Cutbacks have been planned at hospitals across the State in a bid to curtail spending.
Doctors at the Midland Regional Hospital in Mullingar have been asked to cut medical day cases by 55 procedures a month. They have also been asked to cut return visits by patients to the outpatient department by 30 per cent and that outpatient clinics must finish at 5pm.
At South Tipperary General Hospital in Clonmel staff have been told that one operating theatre is to be shut and six surgical in-patient beds are to be lost. They were also told that day cases should be restricted, the number of endoscopies limited and only essential day-case and emergency gynaecological operations performed.
At the Midland Regional Hospital in Tullamore doctors were told to cancel all elective work for September. However, it is understood a number of surgeons said they would not co-operate unless they received the order in writing.
They were also told that management planned to close an orthopaedic theatre and 15 beds. However, the plan met with stiff opposition and is now being reviewed.
At Ennis General Hospital cuts including the closure of a cardiac clinic and a unit for elderly patients were also planned for this week but are now being reviewed.
The measures are being taken by hospitals to balance their budgets by year's end. Last week the HSE introduced a recruitment ban for September. It also prohibited additional overtime and the use of agency staff as part of a plan to address a €245 million deficit.
The HSE has told staff the measures are not cutbacks but an attempt to realign activity levels with this year's service plans. Minister for Health Mary Harney has insisted no patients would suffer.
The HSE's plan could lead to industrial action. Nurses in Ennis are to start balloting today for industrial action in response to the temporary HSE cutbacks.
Health service unions indicated they will refuse to co-operate with the cost-cutting plans. They also signalled that industrial action could be considered in protest at the cutbacks and the manner in which they were announced.
At a meeting yesterday of the national joint council, the standing industrial relations forum in the health service, unions criticised the HSE's plans which they maintained would affect patient care.
Kevin Callinan, national secretary of the trade union Impact, said the unions would draw up a joint strategy and set out their plans to management by the weekend.
He said unions were looking at non-co-operation with implementing the cutbacks but industrial action could be considered. There had been no consultation with the unions on the cutbacks in breach of various agreements.
The INO said last night that midwives at Portlaoise General Hospital had voted to start industrial action from October 9th in a row with the HSE over staffing levels.