The Health Service Executive's national service plan indicates there is a "funding shortfall" of €100 million in hospital services for next year, after taking account of expected growth costs and initial cost saving measures.

The shortfall will have to be achieved through other savings in hospitals.  

The amount of funding being provided to the HSE to "maintain existing services" next year is up by just 0.8%, or about €100m, according to the plan.

An extra €97 million is also provided for new service developments, including cancer services and disability services.

Meanwhile, the Minister for Health has said there will be no cuts to medical cards next year.

Under the HSE's 2016 service plan, which details how it will spend its budget of over €13bn, 50,000 fewer full medical cards will be issued.

Speaking on RTÉ's Morning Ireland, Minister for Health Leo Varadkar said the Government expects the total number of people who hold medical cards will fall by that number.

The minister said that this year the total number of medical cards issued fell by around 40,000 as people returned to the workforce and incomes increased.

He said the Government projects something similar next year but insisted there "will be no cut to medical cards, no change in income limits, no reviews". 

The plan sets out what is likely to happen with hospital waiting-list targets next year, given the funding.

The HSE expects to be 70% compliant with the target of having no adult wait longer than eight months for an inpatient or day-care procedure.

It expects to be 60% compliant with the target of having no child wait longer than 20 weeks, for a planned procedure.

It also expects to be 85% compliant with the target of having no patient waiting longer than a year, to be seen at an outpatient clinic, for the first time.

The service plan warns about the cost of public-pay policy and approved pay-cost growth in areas which have not been funded in 2016, including staff increments.

It also says there is a question over the ability to keep the Fair Deal waiting time at four weeks.

The HSE outlines the risks to delivering the national service plan and these include:

- demand for services going beyond planned and funded levels;

- the capacity to recruit and retain certain staff;

- the limitations of the HSE's current financial systems;

- the approval of new drugs and the control of existing drugs at or below 2015 funding levels.

Hospitals in Ireland are now organised into seven groups.

Each has a chief executive, with full legal authority to manage the group in line with the service plan and subject to budgets being allocated to the group.

Each of the seven groups will now prepare an operational plan for 2016, setting out the services they can deliver under the money provided.

HSE Chief Executive Tony O’Brien has said that if the service plan works, it will deliver a better health system by the end of 2016.

"This year’s service plan does have more money than last year's service plan. It does allow us to move forward the reform agenda. It does allow us to pursue integrated care models which help us to join up the way services are delivered,” Mr O’Brien said.

“And if we land all the things that we aspire to do in this service plan, the key thing, irrespective of the national vision for the next 30 years, at the end of 2016 we will have a health service which is slightly better than the one we have today," he added.

Opposition critical of Government's health policies

Sinn Féin health spokesman Caoimhghín Ó Caoláin has said that the party's proposed one-tier health system would mean that private health-insurance holders would access their healthcare needs solely through private providers.

Speaking on RTÉ’s News At One, he said that universal health care can be based on a progressive taxation system.

"Fine Gael and Labour, unfortunately, and the Fianna Fáil party, are all wedded to the funding model that is based on universal health insurance.

"We are absolutely opposed to that formula. It is not workable, it's absolute nonsense," Mr Ó Caoláin said.

Fianna Fáil spokesperson for health Billy Kelleher earlier blamed what he described as "short-sighted" decisions by Government for putting the health system under pressure.

Speaking on RTÉ’s Morning Ireland, Mr Kelleher said the Minister for Health's promise of maintaining services next year is not giving people much hope.

He said the health sector needs additional recruitment and investment.