Two major health reports have been published on the future of smaller hospitals and re-organising the overall hospital system around six hospital groups.
No small hospital is to close, but some services will transfer to bigger facilities, while smaller hospitals are due to gain other more routine services.
Most of the ten smaller hospitals involved have already seen an end to their 24/7 Emergency Departments and the loss of major surgery, on grounds of safety.
The Framework for Smaller Hospitals document says these hospitals will develop more day surgery, chronic disease management, medical services and diagnostics and will provide more services rather than fewer.
The nine smaller hospitals concerned are: Our Lady's Navan, Louth County, St Columcille's Loughlinstown, Mallow, Bantry, Ennis, Nenagh, St John's Limerick and Roscommon County.
The second report on hospital groups proposes that around 50 hospitals be organised into six hospital groups, centred on large teaching hospitals with links to universities.
The aim is to better manage services and prepare the system for planned independent trusts and boards.
Hospital groups will have their own budget, will pool resources and posts will be filled centrally.
The groups will cater for populations of around 750,000 people and will be organised around four major academic teaching hospitals: St James's, Beaumont, Cork University Hospital and Galway University Hospital, as well as the Mater and Tallaght in Dublin, the Mid West Regional Limerick and Waterford Regional.
The development comes against the backdrop of the Health Service Executive’s latest performance report for March, which warns that it could face "a very significant level of deficit" at the end of the year if cost containment measures and other controls are not achieved.
The HSE says its core deficit at the end of March could be €33m, if surpluses on some services are temporary and are excluded.
The executive has budgeted for savings of €150m from Croke Park II, which was rejected by unions.
Minister for Health James Reilly said the reorganisation of hospitals will result in safer services for patients.
Speaking on RTÉ’s Prime Time, he said there was a lot of fragmentation and duplication in the hospital service at the moment and he said the new system would rectify this problem.
Mr Reilly reiterated that no acute hospital will close as a result of the reorganisation because he said the capacity in the system would not allow for this to happen.
He said that smaller hospitals were trying to produce and provide all level of services which he said was not safe and could not continue.
Fianna Fáil health spokesperson Billy Kelleher has claimed that the absence of any specific commitments for a number of hospitals nationwide in the Hospital Groups Report must raise questions about their future role in the health system.
Sinn Féin Health spokesperson Caoimhghín Ó Caoláin said the reports provided more questions than answers.
He said communities will look to them in vain for any definite information about the fate of their hospitals.
Meanwhile, the Irish Hospital Consultants Association said it is seeking a meeting with the Health Minister and health services management on the organisational arrangements and the resourcing of the new plans.