Minister for Health Leo Varadkar has said he is very hopeful that this time next year things will be improving in regards to HSE waiting times and budget overruns, but that "they won't improve in the next few months".

However, he said, that is "contingent on getting a realistic budget in place for next year."

He was responding to Health Service Executive figures, which show that more people are waiting longer for appointments and operations.

The minister said the figures "show that the health service is under a lot of pressure against a backdrop of a freeze on spending and a freeze on recruitment".

He said it was difficult to know what to say to the over 400,000 people waiting for inpatient and outpatient services.

Too many people are waiting too long to see a consultant and waiting too long for an operation, he said.

But he said "the reality is that there are more and more people attending A&E departments and calling ambulances".

He said "those people have to be seen even though there has been no increase in budgets or staff".

However, he said there were some positives in the figures.

In primary care, waiting times for physiotherapists and occupational therapists have decreased, he said.

There has also been an improvement in end of life care and childhood health surveillance, he said.

The minister is in discussions about the budget available to the Department of Health next year, but said things for the next couple of months will continue to be very difficult.

The Irish Nurses and Midwives' Organisation has said the latest waiting list figures confirm that patients are suffering due to inadequate health funding.

The union said the trend will continue unless extra funding is brought forward immediately.

INMO General Secretary Liam Doran said that no one should hide behind reform programmes, recruitment embargoes and other management speak to avoid doing what needs to be done.

The HSE said it is continuing to experience a significant increase in demand for its services, which is reflected in an upward trend reported in waiting lists for July 2014.

It says that in collaboration with the Special Delivery Unit, it will continue to work with all hospitals to tackle waiting lists for the remainder of this year.

The latest performance figures from the HSE show that hospital waiting lists are increasing and University Hospital Limerick has overspent its budget by over €17m to July.

The HSE currently expects its year-end deficit to be €510m.

The July performance report shows that the number of adults waiting more than eight months for a procedure is up nearly 20% and the number of children waiting more than 20 weeks is up 16%, compared with the previous month's figures.

The HSE has said some outpatient waiting list targets have been breached by more than 300% since January and there are 360,753 people waiting to be seen at a clinic.

While the number waiting more than a year to be seen has decreased, there are still more than 37,800 patients waiting beyond this period and in a small number of cases waiting more than four years.

The July performance report shows there are 54,066 people on a waiting list for an inpatient or day case procedure - 48,996 adults and 5,070 children.

A further 3,247 people are waiting for a gastrointestinal endoscopy check, up 20% on the June figures.

The HSE said the number of referrals for planned operations and outpatients has increased month-on-month, and the number of patients admitted to emergency departments has also been rising.

The hospitals with the longest adult waiting lists, for inpatient or day case care are:
- Galway University Hospital 6,462 patients
- Beaumont Hospital 5,127
- Mater Hospital 4,594
- St James's Hospital 3,927
- Cappagh National Orthopaedic Hospital 2,823
- Waterford Regional Hospital 2,571

The hospitals with the longest child waiting lists for an inpatient or day case treatment are:
- Midland Regional Hospital, Tullamore 550
- Galway University Hospitals 362
- University Hospital Limerick 337
- Waterford Regional Hospital 306

The HSE said it is preparing an analysis of the growing rates of waiting list target breaches to project extra elective capacity needs but in the context of cost containment.

Comparing July 2014 to July 2013, the number of patients waiting in emergency departments on a trolley for ward bed accommodation is up by 10%.

One factor has been an increase in the complexity of cases attending emergency departments.

Other contributory factors are continued bed closures this year as a cost-containment measure, refurbishment or cleaning of beds and a rise in "delayed discharges" in hospitals, which now number more than 660 patients.

The level of funding to enable these patients to be discharged is not available, the HSE has warned.

The HSE's reported deficit to July is €285m.

Other hospitals that have heavily overspent their budget are:
- Waterford Regional Hospital €8.9m
- St Vincent's University Hospital €8.5m
- Mater Hospital Dublin €7.7m
- Beaumont Hospital €7.3m
- Cork University Hospital €7.3m
- Letterkenny General €6.9m

The HSE's spend on agency staff was €194m to July, compared with €131m for the comparable period last year.