The Health Service Executive has proposed cutting the number of people admitted to hospital for treatment this year by around 54,000 in a final draft National Service Plan for 2010.
The plan was submitted to the Department of Health late last month for approval.
The document, seen by RTÉ News, provides for just under 541,000 inpatient treatments this year, compared with nearly 595,000 last year and says there will be 'a real reduction in the level of inpatient care provided' this year.
However, a spokesperson for the HSE said the final service plan had still to be approved by the board, which is meeting tomorrow, and further amendments are expected.
The draft plan - dated 22 December - estimates that around 1,500 HSE staff will retire this year at a cost of €167m, which will come out of core services budgets.
It says that the moratorium on recruitment and the number of people taking incentivised early retirement will affect the ability of the HSE to maintain services this year at 2009 levels in all facilities.
It provides for 679,510 day cases this year - an extra 769 treatments compared with last year.
It says some of the inpatient cuts are being achieved through 'emergency admission avoidance' and the provision of alternative community-based services.
There is a commitment that patients who require admission will secure this within six hours of registering at an emergency department.
The draft plan also warns that the total income raised by the HSE could fall this year if new arrangements with drug companies fail to deliver predicted savings, there are higher than expected successful appeals under the repayment of illegal nursing home charges scheme and unanticipated costs in the clinical indemnity scheme, which deals with claims for medical negligence from patients.
It says the HSE is planning to save an extra €106m in value for money measures, cutting costs for professional services, heat light and power and insurance.
The document estimates that the HSE will have to live within a employment ceiling of 109,600 staff but the full details of this have still to be finalised with the Departments of Finance and Health.
