The Health Service Executive has announced cuts of €130m to be implemented by the end of the year.

The HSE said that if it did not take robust action now, the deficit could be €500m by year end.

The deficit at the end of August stands at €259m.

The major cuts are in agency and overtime, home help hours, home care packages, provision of personal assistants, medical equipment and drugs.

Agency staff will be cut by 50%, overtime by 10%, home help hours 5.5% and 200 home care packages will be cut each month resulting in 800 home care packages being cut this year.

50,000 medical card patients will no longer get drugs or products for nutrition, weight loss and helping to manage cholesterol.

The products being suspended from the medical card scheme are glucosamine, a nutritional supplement; Orlistat, which assists weight loss and Omega-3 Triglycerides, which helps manage cholesterol.

The HSE said the measure would save €6m. It said these drugs, which are prescribed by GPs, are viewed as less cost-effective and of limited patient benefit.

The HSE says it is inevitable that there will be some impact on service delivery but it will seek to minimise the direct impact on patients.

It said the HSE had been set clearly defined budget targets by the Troika and the Government.

The Irish Nurses and Midwives Organisation has warned that patients will be put at risk.

General Secretary Liam Doran told RTÉ News that the savings could be achieved without affecting patients if the Government proceeded with its plan for greater generic drug prescribing and charging private patients who occupy public beds.

Mr Doran said that what happened in the HSE North East this week in terms of staff cuts and bed closures was a microcosm of what was to come nationally.

He said that the HSE did not appear to see the clinical risk that will result from the planned cuts.