A government measure which imposes charges on private patients occupying public beds has left some cash-strapped hospitals worse off.
It comes at a time when hospitals are so over budget that a range of cuts in patient services is inevitable in the coming months.
The new law came into effect in January, ending the previous system which meant private health insurers could not be billed if one of their members was put in a public bed.
However, while the fee is now being imposed, the overnight rates which the hospital can charge private patients are now less in some cases.
This has led to an unexpected reduction in the first two months of the year in the total amount some hospitals have recouped in bed fees from private patients.
The HSE said "hospitals which traditionally had a high proportion of income from day case activity are now encountering a reduction".
This is due to a cut in the rate per day and in-patient cases and the loss of the statutory in-patient charge – which is a €75 overnight charge imposed on everyone who does not have a medical card – under the new arrangements.
The charging of private patients in public beds was designed to raise €30m this year but it remains to be seen how much it will generate.
Dr Tony O'Connell, the new head of acute hospitals in the HSE said the plan for €34m in savings does not stand up and a more realistic figure was €9m. They now have to submit new cost-cutting plans.