Minister for Health Simon Harris has said there needs to be senior clinical decision makers in all hospitals over the Christmas period to manage overcrowding.
On his way into a meeting of the Emergency Department Taskforce, Mr Harris said senior doctors were required to discharge and admit patients and to ensure access to diagnostics during the holiday period.
He said that the way Christmas falls this year, it will be a particularly long holiday period.
Mr Harris also said it was utterly unacceptable that a 103-year-old woman had to spend close to 15 hours on a trolley at the Midland Regional Hospital, Tullamore last week.
The minister said he expects the Health Service Executive to do everything possible to meet the maximum threshold of having no more than 236 patients on a trolley on any given day.
Figures from the Irish Nurses and Midwives Organisation (INMO) showed there were 352 patients on hospital trolleys or wards waiting to be admitted to a bed this morning.
The number on trolleys in emergency departments is 259, which is 23 cases higher than the maximum allowed under the HSE's new target, which came into force on 1 December.
The hospitals worst affected were Cork University Hospital with 34 patients waiting, South Tipperary General with 29 and Beaumont in Dublin with 28.
Mr Harris said that while the latest overcrowding figures were unacceptably high, the number of patients on trolleys this year was less than last year.
There were a large number of bed closures currently due to a significant rise in infections and the winter vomiting bug, which was adding to pressures, he said.
INMO General Secretary Liam Doran said it is too late to invent extra beds this month, but said more has to be done on staffing to deal with the pressures.