Hospital patients are being fed a diet of chips, battered sausages and frozen pizzas -- in direct contravention of the Department of Health's own guidelines.
The sick and elderly in more than 100 public hospitals and nursing homes are being offered highly processed foods such as potato waffles, pies with just 10pc meat, chicken nuggets and cod goujons containing as little as 50pc fish.
Nutritionists said the high-fat, high-calorie menus "beggar belief", and one consultant said he had seen heart attack patients being fed rasher, egg and chips in a coronary care unit.
The HSE will buy almost 90 tonnes of frozen chips, 62,000 sausage rolls and other highly processed foods for patients in the public health system over the next four years.
The move flies in the face of healthy eating guidelines published just last summer by the department, which recommend that such foods be avoided.
The HSE slashed €9m from its food costs by achieving "efficiencies" over the past two years.
It comes at a time when 60pc of the adult population and one in four schoolchildren and teenagers are overweight or obese.
Tender documents seen by the Irish Independent show the frozen food requirements for more than 100 hospitals and nursing homes over the next four years.
They reveal that patients and nursing home residents in Clare, Galway, Tipperary, Galway, Roscommon, Mayo, Donegal, Sligo and Leitrim can expect to eat a range of highly processed foods while under medical care.
This tender only covers nine of the 26 counties. But the purchase of highly processed foods is likely to be endemic across the entire public health system, sources said.
Last year, some 1.4 million people were treated in public hospitals as day cases or following admission.
Nutritional specialist Dr Donal O'Shea said it was "farcical" that the HSE was buying these types of food at a time when a national taskforce was attempting to tackle obesity.
"I've been concerned about what is available in hospitals for a long time," he said.
"If the hospitals aren't promoting healthy eating by what they do, you can't expect patients to get the message. I've been horrified going into a coronary care unit and seeing patients served up with rasher, eggs and chips.
"How are we still at this point? This tender just causes a sinking feeling of being in a farcical situation at a time when an obesity taskforce is trying to tackle this."
The Irish Heart Foundation (IHF) described the HSE's food order as "extremely concerning".
"The quality of food they are tendering for is extremely concerning. It's against what we're trying to do in terms of tackling obesity," spokeswoman Maureen Mulvihill said.
"When you process foods it also reduces nutritional value. This is not the kind of food the IHF would advise anyone with responsibility for cooking in the home to be buying. It is of concern that the HSE should be setting the gold standard, but this falls far short of that."
Last year a maternity hospital was forced to review its menu after a picture of a meal served to one of the patients was posted online. The Coombe said a sausage roll, overcooked potato wedges and a dollop of ketchup was "unacceptable", and promised to review standards.
Patients groups say the new revelations raise questions about the quality of food being served to the ill.
And nutritionist Aveen Bannon said while patients needed a high-protein, high-calorie diet in hospital, there were healthier options available than chips and battered sausages.
"All fats contain the same calories, but you want them to come from better types," she said.
"It beggars belief that these types of products are going to go into hospitals where people are trying to get better."
The tenders asking for processed foods come despite the department last year publishing two healthy eating guides aimed at tackling obesity.
"Prepare and cook your meals using fresh ingredients. Ready-meals. . . tend to be high in fat and salt and should not be eaten regularly," it advises.
"Choose healthier cooking methods like steaming, grilling, baking, roasting and stir-frying instead of frying foods. Limit bought fried foods, such as chips."
The department said the HSE was a party to the healthy eating guidelines, and that hospital menus were prepared by trained personnel to meet "nutritional standards /requirements".
The HSE defended the spend, saying processed foods represented a very small part of the frozen food tender.
"While seeking to achieve greater value for money for the taxpayer, the HSE has maintained the high quality and standards of the food purchased," it said in a statement.
"Hospital menus are planned by trained personnel in order to meet the nutritional standards/requirements. Specific dietary requirements are planned in conjunction with the relevant professional."