No group will be allowed to stand in the way of change in the health service, Minister for Health Mary Harney will warn in a major policy statement later this week.
Ms Harney is expected to use an address to the annual conference of the Irish Nurses' Organisation (INO) on Friday to claim that resistance to change in the health service has gone on for too long.
The Tánaiste is expected to signal that in future "those groups that were prepared to innovate and change would be rewarded".
She may also indicate that the performance of management in the health services could in future be a criterion for determining levels of funding.
Ms Harney's insistence on change will come at a time of trouble in the health service on a number of fronts.
The INO is to consider emergency motions at its conference this week. These will decide on a response to moves by health service management to withhold pay rises due next month, and to place additional beds in existing wards to ease pressure on hospital accident and emergency departments.
The Health Service Executive (HSE) is seeking to withhold a 3½ per cent pay rise due to 30,000 nurses over an alleged refusal by the INO to co-operate with the introduction of new healthcare assistant grades in hospitals.
INO general secretary Liam Doran has warned that if the pay increases were withheld, it would have national repercussions and could lead to industrial action.
The INO has claimed that the decision to cite the union for alleged breaches of the Sustaining Progress and benchmarking agreements was "a set-up" to hit back at nurses for highlighting problems in accident and emergency departments in recent weeks.
The HSE has strongly denied this claim. It has argued that the row over the healthcare assistants "predates and is totally separate to the issue of accident and emergency departments". A HSE spokesman said the row over healthcare assistants was, in essence, "an old-fashioned demarcation dispute".
Department of Health sources last night also rejected claims that the INO was being victimised.
Although the Government has embarked on a major reform programme in the health service over the last year or so, to date change has largely been confined to the administrative area, with the abolition of the health boards and the establishment of the Health Service Executive.
Meanwhile, in a statement last night the HSE said that almost 90 patients requiring intermediate care, who were previously occupying beds in acute hospitals, will have been moved to beds in the private sector by the end of the week.
