Hospitals and voluntary organisations, as well as the ambulance service, have been ordered by the Health Service Executive (HSE) to try to reduce their staff numbers by 1,000 before the end of the year.
It said St James's Hospital in Dublin should aim to reduce its staff numbers by 33, while Cork University Hospital should try to reduce staff numbers by 25.
It also said Our Lady of Lourdes Hospital in Drogheda should try to cut 10 posts, Limerick Regional should target 20 and Galway's University College Hospital should target 23.
Many other hospitals are also mentioned, including Our Lady's Hospital for Sick Children in Crumlin, Dublin, where a reduction of 13 jobs is sought, and Our Lady's Hospice in Harold's Cross, Dublin, where the loss of four jobs is sought. The ambulance service has been asked to try and cut 11 posts.
The details are contained in a letter from the HSE's director of human resources, Martin McDonald, to service providers in March, but only came into the public domain yesterday.
Opposition parties accused Minister for Health Mary Harney of presiding over cutbacks in a health system not able to meet patient demands. However Ms Harney and the HSE insisted the jobs being targeted were not those of front-line staff. The HSE stressed its plan was to try and reduce staff numbers through "natural wastage".
This effort, which is repeated annually, was an attempt to "trim fat where possible" from the HSE, a spokesman for the executive said.At the same time up to 5,000 new jobs would be created in the health sector this year to deliver new services.
Ms Harney said there would be no reduction in patient services. The target was a 1 per cent reduction in the number of staff delivering existing services, and she believed this "efficiency" was not a big challenge.
"We believe we have more than enough people working in the different areas of the healthcare system to deliver the existing services."
The HSE document, leaked to Newstalk radio station, did not state that front-line positions should be protected, and the fact that it specified individual hospitals for job reductions caused concern.
Fine Gael leader Enda Kenny said he would be very concerned if the rationalisation process was to target front-line staff rather than eliminating "a bureaucratic bulge in middle management".
"This concerns me greatly because I understand that the cuts could be coming in the front-line services - they could be ambulance drivers, they could be hospice workers, they could be people doing front-line duties.
"At the same time you have an embargo on public service recruitment and you can't take on personnel to deal with cystic fibrosis, you can't get midwives in Drogheda."
Labour leader Pat Rabbitte said the last thing the health service needed was to lose front-line staff. If 1,000 front-line staff were being let go when the system was "creaking at the seams" it was outrageous.