Health spending is to be cut by over €1.4bn over the term of the four-year plan.

Next year, the cut will be €746m, to be achieved through reduced spending on demand-led schemes like the medical card scheme and drugs payment scheme, the cost of drugs and medical equipment, non-core pay and savings from the Health Service Executive's early retirement and voluntary redundancy scheme.

Charges for private hospital beds will also be increased, which is likely to push up the cost of private health insurance.

Professional fees for GPs and dentists are to be cut and the pay for all newly-appointed consultants, doctors, nurses and all HSE staff will be reduced by 10%.

HSE staff numbers will be reduced by around 1,500 each year over the term of the plan, totalling 6,000, through natural wastage.

There will be changes to the range of dental services and a new graded level of support under community health schemes, based on income levels.

All the restrictions on trained family doctors who wish to treat medical card patients are to be abolished.

The four-year plan also provides for competition in the medical and other professions to be overseen by an independent figure, reporting regularly to Government.

Capital spending in health will be €400m next year.

Older people are to face charges for community health support services, based on their income, under a new scheme similar to the Fair Deal nursing home system, according to the Government's four year plan.

Eamon Timmins of Age Action Ireland said that older people will now have to pay for services like home help, home care packages and day care services which was unfair.

The four-year plan says that building on the success of the Fair Deal scheme it will introduce 'an approach to community support for older people which takes need and financial means into account on a nationally consistent basis'.