The doctors' union, the IMO has urged that any measures taken to reduce the HSE's projected €104 million deficit for the end of 2013 must not impact further on patient care.

It claims savings can be found in other areas.

The IMO claims the HSE is missing out on savings of up to €200 million by failing to introduce new work practices with hospital consultants, which were agreed in September of last year

The doctors' union also estimates the HSE is foregoing further savings of more than €30m by failing to implement measures relating to the transfer of tasks from non-consultant hospital doctors (junior doctors) to nursing staff already agreed with the IMO and other unions under the Haddington Road Agreement.

"It is incredible that the HSE has failed to implement the changes for consultants and NCHDs agreed with the IMO that could save hundreds of millions of euro," said Steve Tweed, IMO Director of Industrial Relations.

"The HSE has only itself to blame for the failure to achieve these savings. It cannot be allowed to make patients and health service staff pay for this failure by cutting frontline services and seeking more from already overstretched staff," he said.

The IMO says health workers and pay-related issues are being blamed for the deficit at a time when these workers have taken substantial pay cuts and reduced benefits in addition to increasing their working hours;

It says it is also concerned that the HSE will use the 'blunt instrument' of cutting patient services - 'a short term panic measure that will inevitably lead to greater expenditure in the longer term.'