Patients on waiting lists to be treated privately or abroad
Hundreds of surgical operations and specialist appointments will be outsourced to private health providers amid spiralling waiting lists.
Some patients on public waiting lists may even be sent abroad, as hospitals battle to deal with the worrying backlog.
Beaumont, Connolly and Drogheda hospitals - which have suffered some of the worst trolley gridlock in emergency departments since the beginning of the year - have issued a tender for the work, the Irish Independent has learned.
The tender will see 500 endoscopies and 200 colonoscopies outsourced along with 50 patients needing ear, nose and throat surgery.
Another 300 are to be offered to see a dermatologist for skin conditions privately.
Other hospitals which are part of the Royal College of Surgeons Hospital of Ireland (RCSI) Group, include Cavan and the Rotunda. Louth County Hospital and Monaghan are also likely to be involved in the outsourcing.
It comes against a big spike in waiting lists nationally as a result of surgery cancellations - because patients admitted through emergency departments had to be given priority for beds.
Health Minister Leo Varadkar admitted the outsourcing of some waiting list work will be necessary. It is needed to bring down delays and meet targets to have nobody waiting longer than 18 months for surgery or an outpatient appointment by the end of June.
Mr Varadkar said it is being left to the hospitals, or the hospital groups which they are part of, to decide if they want to outsource work.
"We will need help from the private sector. Some may be sent overseas," he said.
"It will be expensive but it needs to be done," he told the Oireachtas Committee on Health.
He was particularly concerned about the numbers of children who need spinal surgery - and some of these young patients have already had operations in the Blackrock Clinic and Cappagh Hospital as part of outsourcing.
Mr Varadkar also said if more GPs received training in areas such as dermatology, there would be less need for specialist referrals.
The most recent figures showed more than 412,000 are on waiting lists to see a specialist and nearly 10,000 are waiting more than a year.
Liam Woods, who is in charge of acute care in the HSE, said yesterday nearly all patients needing surgery are now waiting no longer than 18 months. But the deadline has only been achieved for 60pc of those on outpatient lists.
The RCSI group, which is funded by the HSE, has not disclosed how much it will be spending on the outsourcing - but it is necessary to reduce a backlog, even though it will cost more per patient than if it was done in-house.
Private hospitals can now tender for the work and use their own doctors, or pay consultants a fee to see and treat the patients.
The tender said that it wants the work completed by the end of June.
A spokesman for the HSE North East said: "Many of our sites have physical capacity without resources, so the option to provide the service on one of our sites has been included.
"This would involve healthcare professionals delivering the service on our site but contracted to a different employer. Other options to be explored by bidders is the provision of these services in other sites, such as private hospitals or clinics."
Other hospitals are now expected to have to outsource their waiting list surgery and outpatient appointments in a bid to reduce backlogs.