Safe frontline staffing levels must be protected in plans by health chiefs to axe 4,000 jobs, unions said.
The Health Service Executive (HSE) confirmed the cuts will be made as it slashes 721 million euro from this year's budget.
Health Minister James Reilly claimed the health sector will still have the capacity to improve services even though funding levels have to fall.
"This has been achieved with better planning and greater efficiencies," he said. "2013 will be a challenging year but our task is to cut the cost of services while at the same time not cutting the level or quality of services."
The HSE's national service plan outlines how it will spend its budget of 13.4 billion euro this year, which includes hospitals carrying forward a projected deficit of 271 million euro.
Elsewhere 40,000 pensioners will lose their medical card as the income eligibility is lowered, while an extra 60 million euro will be cut from the primary care budget.
The Irish Nurses and Midwives Organisation (INMO) said it fears the job cuts - in addition to 8,000 already lost in the past two years - will compromise the ability of the health service to meet targets.
Liam Doran, general secretary, demanded that safe staffing levels remain on the frontline. "This is critical particularly in the context of the comparative staffing survey the INMO published two months ago, which confirmed Irish staffing levels are significantly below that which apply in the UK," he added.
Tony O'Brien, director general designate of the HSE, said: "Despite the ongoing challenges, this plan provides for significant investment in key priority areas including mental health, primary care, ambulance services and both colorectal screening and diabetic retinopathy screening programmes.
"New investment is being funded by targeted savings and cost reductions in the primary care schemes and cost of drugs and in delivering greater savings through the Croke Park Agreement."