Senior Fianna Fáil TDs have warned they are prepared to pull their support for the Fine Gael-led minority Government if the chaos in the country's overcrowded hospital is not addressed by next winter.
There are growing concerns among key figures in Micheál Martin's party over the Government's handling of the trolley scandal, which saw more than 600 patients left waiting for treatment in cramped hospital corridors and wards .
Angry Fianna Fáil TDs said a failure to resolve the trolley crisis by next winter would be seen as a breach of the confidence and supply agreement which commits to improving public services.
The party's health spokesman Billy Kelleher said Health Minister Simon Harris should be aware of Fine Gael's arrangement with Fianna Fáil as he battles to reduce the number of patients languishing on trolleys.
"Obviously you don't want to be in a situation where this time next year there has been no improvement in public services, which is part of our confidence and supply agreement and the minister has to mindful of that," Mr Kelleher said.
He said Fine Gael would have to make "major improvements" in the health service to ensure Fianna Fáil continues to support the confidence and supply agreement.
Fianna Fáil TD for Limerick Willie O'Dea said his party would not be able to support a Government that presides over a "complete shambles".
"It is unforgivable that we have a Health Minister who is blaming hospital managers for this crisis. This is a shambles.
"My message to Fine Gael is that they better get out and sort this because we can't keep supporting a situation that allows our hospitals to descend into chaos," he said.
Meath East TD Thomas Byrne said the confidence and supply agreement would be "called into question" if the health service was not improved.
"We are not playing a waiting game, we are not watching polls but we are watching policies.
"We want to be able to go to the polls and say we have delivered on these policies and if we can't do that then the situation is unsustainable," he said.
However, a senior Fine Gael Government source hit back at Fianna Fáil's demands last night and criticised Mr Martin for establishing the HSE.
"It's all very well and good for them to attack us for the trolley crisis, but it was Micheál who created the HSE when he was Health Minister," the source said.