Health unions have sought an urgent meeting with the Government to discuss cuts of over €900m being sought by the Health Service Executive.
The HSE said it may have to seek an extra €400m in cuts next year on top of the €530m outlined in its service plan for 2009.
Unions wish to propose an alternative plan to the Government
RTÉ News has learned that this alternative plan includes proposals for public hospitals to charge the full economic cost of treating private patients.
This would generate over €100m in revenue.
The plan calls for National Treatment Purchase Fund money to be used to keep hospital services going that would otherwise be reduced to avoid public beds closures and fewer operations.
Public hospital doctors, nurses and others are already being paid to do this work.
And it proposes that the Government commit to funding the cost of demand led schemes, over and above what the HSE has budgeted for.
This would ensure that where overruns occur in the medical card and drug schemes, the HSE would not then seek further cuts in overall health services to cover the cost.
The HSE's National Service Plan for 2009 was published yesterday evening, after its contents were reported by RTÉ News, including plans to review 11 accident and emergency units in Dublin and Cork.
The executive said that its plan was completed almost two months ago based on known information at the time.
But with the economic downturn, it warns that many of the developments included in the 90-page document may now be challenged.
The HSE has promised to do everything it can to protect services but said economic downturns mean extra costs with more people needing medical cards and seeking hospital and mental health care.
