Minister for Health James Reilly said that he stands over his decision to add 15 sites to the HSE list of priority primary care locations, including two in his own constituency.
Speaking on RTÉ's News at One, Mr Reilly said that he would be "negligent in his duty" as Minister for Health to exclusively use the urban deprivation criteria and ignore other factors.
Mr Reilly said that in adding new sites to the list he also took into consideration, competition, GP co-operation, the existence of health facilities in the area already and accessibility.
Mr Reilly said that he is aware that Minister of State Roisin Shortall disagreed with that decision, but that if he had to make it again tomorrow he would.
Ms Shortall earlier said that she would like to hear what criteria Minister Reilly used when adding the locations, which had not been identified as priority locations.
Mr Reilly said he added 15 locations to the list of 20 in order to create competition and to put pressure on GPs to make the best case possible to win the primary care centres.
He said that some of the locations on the original list of 20 had no sites, and so in these cases "implementability" was in question.
On the question of confidence in him as minister, Mr Reilly said Ms Shortall's actions spoke louder than words when she voted to back him in the confidence vote in the Dáil on Wednesday night.
This afternoon Mr Reilly was asked if he had spoken to Ms Shortall today to explain his reasons for adding sites in his constituency.
"She is in Balbriggan and I am up here and our paths will cross I've no doubt in the course of the day," he said.
He added that he will always talk to his junior ministers and does so regularly.
While speaking to reporters this morning, Ms Shortall was asked on three occasions if she had confidence in Mr Reilly, but she did not answer.
Instead, she said the Government must recommit itself to the Programme for Government.
She said there was a huge job to be done and it was important that both her and Mr Reilly "work closely together".
Also speaking on News At One, Fianna Fáil health spokesman Billy Kelleher said that there needed to be clarity as to whether or not Minister Reilly interfered with what was supposed to be a transparent selection process.
Sinn Féin's Caoimhghín Ó Caoláin said there was "deep dysfunction at the helm of our public health services".
A spokesperson for the Minister for Health has said the case for including Balbriggan and Swords on the list of priority primary care centres was "absolutely there".
He said the criteria used for choosing the extra 15 centres were not written down, but were the result of consultations with senior officials, and with others both inside and outside the Department of Health.
The Department of Public Expenditure and Reform has said it accepts Health Minister Reilly's thinking in increasing the number of priority primary care centres.
In a statement, the Department said Minister Reilly determined the location of the centres following consultation with colleagues, and that there was a need for competition to ensure cost effective GP buy-in, which led to the increase from 20 to 35 priority sites.
Speaking on RTÉ's Morning Ireland, Director General designate of the HSE Tony O'Brien said it would seem to make sense that if you were seeking to secure 20 facilities that you should draw up a longer list and have wider options.
On the issue of hospital waiting lists, Mr O'Brien said that people who present as urgent cases in outpatient departments are being treated quickly, despite a huge jump in the number of those waiting for appointments.
He said the almost doubling of the number on outpatient waiting lists reported yesterday was due to more hospitals being gradually added to the overall list.
Mr O'Brien said this was part of the process of getting a full picture of how many people were waiting for appointments.
HSE releases figures on beds and agency staff
HSE figures show that nationally at the end of July, 852 inpatient hospital beds were closed around the country, compared with 752 beds the previous month.
However, some of the pressure caused by this was offset by the fact that 19 day-care beds were closed in July, compared with 40 in June.
The report also shows that the hospitals with the biggest dependency on agency staff are: Cavan General (with 17% of the pay bill spent on agency staff), Our Lady's Hospital Navan (15%), Naas General (11%), Bantry General (11%) and the Mid West Regional Nenagh (11%).
The HSE is due to announce details of the impact of its 50% cut in agency staff, a 10% cut in overtime and other measures in each of its four regions soon.