The Health Service Executive has denied claims by the Irish Nurses and Midwives Organisation that proposals to change work practices in the health service will compromise patient care.

HSE National Director of Human Resources Barry O'Brien said the latest round of cuts will help deliver the €290m savings agreed under the Haddington Road Agreement.

INMO General Secretary Liam Doran had earlier said the plan to lower the ratio of nurses to healthcare assistants in an attempt to save €80m this year was unsafe.

Speaking on RTÉ's Morning Ireland, Mr O'Brien said skill mix is being painted as a negative approach, but it is a safe and appropriate measure.

He said the ratios differ across departments, as some units require higher ratios of nurses.

Mr O'Brien said the HSE will put in place the best mixture of staff to deliver the best quality of care.

He said it will recruit junior doctors where it can, including eastern Europe, in order to meet its obligations under the European Working Time Directive.

Nurses say the proposals will put severe strain on frontline health staff and managers.

The INMO has also expressed concern that only essential posts will be filled from October and they will only be filled by graduates and interns.

Speaking on the same programme, Mr Doran said it would mean the de-skilling of the frontline workforce and result in managers taking decisions to close beds.

Mr Doran said the quality of patient care will suffer.