New figures from the Health Service Executive show that acute hospitals have overspent their budgets by more than €63m in the first three months of the year.
They also show that inpatient and outpatient waiting lists are on the increase again.
The HSE said that overspending by major acute hospitals has been the main factor contributing to an overrun of €80 million in its budget to the end of March.
The number of adults and children waiting for an inpatient, or day case procedure, has increased by 1,390 to 50,537, compared with the February figures.
The number of people on the outpatient waiting list waiting to see a consultant is now at 331,281, up by more than 30,500 patients.
The number of patients waiting a year or more to be seen as outpatients has also increased from 4,000 at the end of last year, to more than 14,700.
The specialties with the longest waiting lists for outpatients are:
- Orthopaedics 42,275
- General surgery 37,400
- Ear, nose and throat 37,300
- Dermatology 26,300
The increase in waiting lists comes at a time when the HSE is planning to cut health agency staff and overtime.
It is also trying to impose a revised savings target on acute hospitals of around €56m.
At the end of last year, Minister for Health James Reilly said that no adult should be waiting longer than eight months for a planned operation and no child longer than 20 weeks.
The latest figures show there are 4,350 adults and 821 children waiting beyond those targets.
The hospitals with the biggest deficits are:
- University Hospital Limerick €6m
- Waterford Regional Hospital €4m
- Mater Hospital €3.8m
- University College Hospital Galway €3.3m
- Cork University Hospital €3m
- Sligo General €2.8m
- Beaumont Hospital €2.7m
The HSE's latest national performance assurance report for March said that the scale of the risk and challenge achieving financial breakeven by year end is "extremely significant" as predicted in its National Service Plan for 2014.
The executive said it is not flagging any new financial risks beyond those set out in the service plan, with the exception of a potential shortfall of €40m in acute hospital income.
The HSE said it had already commenced implementation of a robust performance assurance process with hospitals.
It said this assurance process will enable full optimisation of cost containment and Haddington Road Agreement plans and will continue to be progressed over 2014.
Reilly says seasonal factors contributing to figures
Minister for Health James Reilly has said some waiting list figures are up due to seasonal factors.
He said that compared with March 2013, there were now 90,000 fewer people waiting to be seen for the first time at an outpatient department.
The minister said that the number of people waiting over eight months is down 10%.
He said the number of adults waiting for an inpatient treatment over eight months was down, but cases involving children are up by 300.