The Health Service Executive may have to implement further cuts in patient services later this year if it does not resolve a row with staff represented by the IMPACT trade union.
The HSE has warned that it may also take disciplinary measures, including suspension without pay, against staff who fail to perform their duties.
Since January, staff in the public service have been engaging in a work-to-rule aimed at forcing the Government to reverse pay cuts imposed on them.
The work-to-rule has had a serious effect on the HSE because staff represented by IMPACT are refusing to collate and provide financial data.
A confidential management briefing to the HSE board last week stated that as a result, they do not have adequate oversight over how their €14bn budget is being spent or whether the €400m in savings targeted for this year are being secured.
They fear this could lead to unforeseen deficits later in the year, which would require drastic cutbacks, including cutting services for patients.
Management had sought derogation from the industrial action for this work, but IMPACT refused to grant it.
The Labour Relations Commission is to meet HSE management and IMPACT tomorrow in a bid to resolve the row.
However, it is understood that if those negotiations fail to find a solution, preliminary steps towards disciplinary action could commence from Wednesday.
IMPACT Assistant General Secretary Kevin Callinan, who represents around 20,000 HSE personnel, said the union would defend its members if any action were taken against them.
He also said they would not consider deviation from the industrial action until after a process of clarification of issues around the Croke Park Agreement on job security, pay and pensions.
Meanwhile, unions across the public service are balloting on the Croke Park pay and reform proposals - with a majority of union executives recommending rejection.
Senior trade union officials are meeting the facilitator of the deal, Kieran Mulvey, this afternoon seeking clarification of elements of the deal in a bid to reduce opposition to the proposals.
It is hoped those clarifications will emerge before next Tuesday, when the Public Services Committee of ICTU is due to review the situation.
