Three hospitals in the midlands are due to lose up to 140 staff under proposed cost-cutting plans drawn up by the Health Service Executive.
A "break-even" plan drawn up for the Dublin Mid Leinster region of the HSE proposes that about 90 jobs be cut at the Midland Regional Hospital in Tullamore, that more than 30 staff be taken out of the Midland Regional Hospital in Portlaoise and 15 jobs be shed at the Midland Regional Hospital in Mullingar.
The proposed cuts come just days after a break-even plan drawn up for the northeast proposed closing beds and reducing elective surgery and outpatient clinics.
Similar plans are expected to emerge from other areas in the coming days and weeks.
The HSE did not deny the existence of a cost-cutting plan for the midlands hospitals last night but it stressed the plan had not been finalised.
"There is no finalised break-even plan for Dublin Mid Leinster. No decisions have been made. We are facing a challenging year and we are exploring how best to deliver services within budget," a spokeswoman said.
Five nurses at Tullamore hospital have already been told their contracts are not being renewed and the Irish Nurses Organisation warned yesterday that patient safety could be threatened by HSE plans not to renew the contracts of up to 30 nurses at the hospital. It said up to 100 workers in total at the hospital could be affected by cutbacks in coming months.
Joe Hoolan, INO industrial relations officer for the midlands, said dieticians, physiotherapists, occupational therapists and clerical staff could also see their contracts lapse. This would have implications for patient care and "that is very, very worrying", he said.
Fine Gael's Laois/Offaly deputy Olwyn Enright said she heard that up to 140 staff could have their contracts cancelled.
The HSE has refused to comment on the number of employees who could be affected by the review of temporary staff.
A HSE statement said that management at Tullamore hospital was "constantly reviewing all temporary contracts, which is normal practice to enable the hospital to stay within its budget". No permanent jobs were affected and the hospital was maintaining its agreed staff complement.
"These temporary contracts [which include agency staff] that are coming to an end may not be renewed because the purpose for which the person was employed no longer applies, eg to cover maternity leave, annual leave, sick leave, career break," the statement said.
Ms Enright said it had become Government policy to cut back patient services "by stealth" to balance the books in the face of overall budget reductions.
She said she had met "a bureaucratic brick wall" in the HSE when she tried to establish how many staff could be affected.
Asked if the number of staff affected could be as high as 140, a HSE spokeswoman said she could not give any further information.
Ms Enright said hospital services were already under severe pressure. "For example, there is a significant waiting list for hip replacements but the four orthopaedic surgeons at the hospital are only performing one hip operation per week because of the closure of 12 surgical beds and four general beds as part of Government-sanctioned cutbacks.
"So patients are directly suffering as a result of this."