Minister for Health Dr James Reilly has told the Dáil that he is confident that a safe health service will be maintained despite departure of thousands of workers over the last six months.

Around 4,200 workers will have left the health service by end of this month. However, the minister stressed that the situation was dynamic and that figure could change.

Minister Reilly said there is "a very coherent, stringent plan" to deal with crucial areas.

He said staff across the HSE will have to be as innovative and flexible as possible to mitigate against the drop in levels of staffing and funding.

Later, Fianna Fáil's Billy Kelleher raised the delay in processing medical cards and asked Minister of State Roisin Shortall what additional resources will be assigned to deal with the backlog of medical card claims.

Minister Shortall said a single uniform processing system has been established in Finglas since last July.

She said it is expected that the new arrangement will lead to a more accountable system.

Elsewhere, Sinn Féin said a leaked health service plan for the Dublin North East region revealed job cuts and bed closures.

Speaking during Leaders’ Questions in the Dáil, Gerry Adams said that the HSE plan reveals that services will be reduced by a further €120m this year.

The Sinn Féin leader said 400 staff would retire by the end of this month and a further 561 jobs will be cut.

He added that the plan states that 205 long-term beds in older peoples' services will be closed and that the closure of two nursing homes is also being considered.

In response, Taoiseach Enda Kenny said that many community hospitals are in old buildings and the way health services are delivered has to be changed.