The Irish Nurses and Midwives Organisation has said that the time for reviewing and analysing the Emergency Department problem is over.
Phil Ní Sheaghdha, the union's General Secretary, told a Joint Oireachtas Committee, that the health service is heading into another winter which is likely to be worse than 2017, unless appropriate action is taken.
She said there had been significant analysis and reports on the problems in the health system and particularly overcrowding, including the ED Task Force Report of 2006, and a 2012 HIQA investigation into safety and governance of care provided at Tallaght Hospital's Emergency Department.
Ms Ní Sheaghdha said an extra 1,224 nurses were due to be recruited last year but this target was not met.
She told the committee that 800 nurses were recruited by December and the bigger problem was the retention of staff.
The Irish Hospital Consultants Association said that around 450 consultant posts cannot be filled on a permanent basis.
It said that some posts are filled on an agency basis at high cost.
The Irish Medical Organisation said there were 1,531 fewer inpatient beds in the system compared to 2007.
It said that the Health Capacity Review showed that the system needed an immediate additional 1,200 inpatient beds and 50 adult critical care beds.
There are 284 patients on trolleys or on wards today, waiting for admission to a bed, according to INMO figures.
It represents a decrease of 20% on the same day last year.
The hospitals with the highest level of overcrowding today are: University Hospital Limerick with 37 patients waiting for treatment, and University Hospital Galway with 28 patients waiting.
Fianna Fáil's health spokesperson has said that figures show that doctors and nurses in Ireland are pretty well paid.
Speaking at the committee, Stephen Donnelly also said that Ireland spends more money on healthcare compared to anywhere else, except in the US.
He said doctors here are still among the top ten in the world in terms of pay and nurses are in the top five.
He asked the IMO, IHCA and the INMO where Ireland was wasting money, given that there is no underinvestment in health.
He asked the unions what the top cost-neutral measures they could propose, given there is very little money available.
Mr Donnelly also asked where any extra money should be spent - on wages, more staff or something else.