Waiting list patients to travel to another county for treatment
Patients on waiting lists in hospitals that fail to meet targets for treatment may have to travel to another part of the country - and see a different consultant.
Health Minister Leo Varadkar said fines will be imposed on hospitals which failed to meet the target of having no public patient waiting to see a specialist or have surgery for more than 18 months.
The funding will instead be given to hospitals meeting targets.
However, patients who are on lists in hospitals that lose money risk having to wait even longer if they choose not to move to another hospital.
Asked what would happen to these patients, a spokesman for the Department of Health said: "They will be treated in chronological order, unless clinical need necessitates that they be prioritised as a matter of urgency - this is a clinical decision, to be determined by the patient's consultant."
He said patients in hospitals where funding was withdrawn may be offered care in another hospital which was part of its group. These hospital groups cover several counties.
However, it may also involve travelling to another hospital group which could be a considerable distance away. They may be treated in a private hospital where they may be seen by a different consultant.
"Patients may, of course, elect to remain on their current waiting list.
"There will also be a small number of cases where the complexity of individual patient requirements is such that it would be inappropriate to refer them to another hospital," said the spokesman.
He said patient choice would be "facilitated as much as possible".
However, the plan was described as "crazy" yesterday by leading Dublin consultant Prof Michael O'Keeffe, an ophthalmologist at the Mater Hospital.
Prof O'Keeffe said some hospitals, such as Temple Street Children's Hospital in Dublin, were having to operate rolling theatre closures because of a lack of nurses.
It means around 80 to 100 operations a month for children are being cancelled.
"Hospitals will end up cutting in other areas, under this plan," he warned.
The most recent figures show that more than 12,000 public patients are on waiting lists for a specialist appointment or surgery.
The minister was speaking after attending a meeting of the implementation group for the task force plan to ease emergency department overcrowding which is set to worsen.
Mr Varadkar said 300 extra beds were planned to be opened before the end of the year but this would involve capital works and face difficulties due to a shortage of nurses.
Consultants in some hospitals had not changed their work practices and were not discharging patients at weekends to reduce pressure on beds, he insisted.
However, Dr Gerard Crotty, President of the Irish Hospital Consultants Association said acute hospitals do not have sufficient resources to provide a seven days a week service.
"Despite this, consultants currently provide 24/7 on-call care and treat patients in hospitals over the weekends.
"As a result of the medical brain drain, consultants are extremely overstretched with acute hospitals having far too few consultants to provide high quality safe care to patients," he said.
"This has been exacerbated by over 230 permanent hospital consultant posts not being filled currently.
"Our acute hospitals are still failing to recruit the number of consultants they need," he added.