Health unions and patient campaign groups have raised concerns about plans by the HSE to review full-time A&E services at eight Dublin hospitals and three in Cork.
The details are contained in the executive's 2009 service plan, which has yet to be published but has been seen by RTÉ News.
The Irish Hospital Consultants Association says that while 24-hour accident and emergency services can not be provided at every hospital, any replacement services must be as least as good as what currently exists.
Its deputy head Donal Duffy said that given the population of Dublin and the large number of patients on trolleys in A&E each day, more services rather than less were needed.
He accepted that some rationalisation of services was needed and predicted that next year would be a very difficult one for patients.
Meanwhile, the Irish Patients Association says it hopes the HSE's plan is not a resurrection of the 2003 Hanly Report. Stephen McMahon said all those affected should be involved in consultation on such a major development.
The Labour Party has called for the immediate publication of the plan. Its health spokesperson Jan O' Sullivan said closing full-time A&E units, particularly without providing additional resources to other units, would simply make a bad situation worse.
Harney wants faster cancer checks
The 90-page HSE service plan for 2009 has been approved by the Health Minister.
Next year, the HSE plans to cut inpatient admissions, the average length of hospital stay, and outpatient numbers, while increasing day case procedures.
The measures also envisage rationalising A&E services in the mid- west and the provision of 24/7 emergency services by three paediatric hospitals in Dublin.
Around €530m in savings is being sought next year.
The plan will see the HSE cutting the number of management and administration grades by 3% and it must stay within a staff ceiling of 111,575 people.
In a letter to the Executive, approving its 2009 plan, Minister for Health Mary Harney has directed it to ensure that colonoscopies are performed within one month of referral by a doctor.
Last week, a report from the National Treatment Purchase Fund found that delays of up to eight months were occurring in some cases in relation to these simple cancer checks.
The letter also says the HSE's progress in implementing the specific recommendations of some investigations into a number of serious incidents is a matter of 'serious concern'.
The minister has also sought further 'tangible evidence' of improvements in hospital hygiene and has directed the executive to report, on a monthly basis in future, on performance in this area.
