The HSE has told its health regions to control spending on overtime, agency staff and recruitment.
In a letter to senior managers, its CEO Anne O' Connor said the financial position is now significantly over budget and at the end of March was €250m in excess of its spending plan for the year.
Each of the six health regions have been notified of the measures they need to take to get back in budget, including some having recruitment pauses for non-frontline non-critical posts.
Ms O' Connor said the situation is serious and needs to be addressed through the year.
Meanwhile, in a separate response to concerns raised at the Irish Nurses & Midwives Organisation annual conference over unsafe staffing, the HSE said that the six health regions are now responsible for planning and delivering services and managing their own budgets and staffing.
It said that each health region has been provided with its own specified number of whole-time equivalent staff and budget and can, within that approved number, replace and recruit staff according to the priorities in their regions.
In relation to reports of burnout among nurses, the HSE also said it is committed to promoting employee well being and psychological safety in the workplace.
General Secretary of the Irish Nurses and Midwives Organisation (INMO) Phil Ní Sheaghdha said members are regularly reporting that verbal and physical assault is on the rise which in turn is leading to increasing incidence of burnout.
Speaking on RTÉ's Morning Ireland, Ms Ní Sheaghdha that every day 12 nurses face some form of abuse and that the INMO survey shows it is one of the main contributing factors to peoples' intention to leave, as they feel their workplace is very unsafe.
This, she said, is causing them to be unwell and feeling very stressed even before they start their shift.
She said at present, there is a shortage of around 5,000 nurses in Ireland, not including the 2,500 nurses who are on maternity leave.
"Legislation is required to implement good policy because we just do not trust the Government or the employer at this point in any way that they will implement what’s right because finance and fiscal policy comes first.
"We have to put safety first, for the staff and for the patients," Ms Ní Sheaghdha said.
ICTU 'deeply concerned'
The Irish Congress of Trade Unions (ICTU) staff panel of health unions has said it is deeply concerned by reports of the HSE's decision to pause recruitment for non-frontline and non-critical posts, in a number of regions, without prior engagement with trade unions.
It said the move appears to breach the 2025 Workplace Relations Commission agreement on the HSE’s Pay and Numbers Strategy and a Labour Court recommendation, all of which require meaningful consultation with unions before such measures are implemented.
While the ICTU staff panel said it supports measures to reduce excessive agency spending, the unions position has consistently been that this must be achieved through increased direct employment.
Ashley Connolly, Fórsa’s Head of Health & Welfare division, said that yet again the HSE had failed to engage with the trade unions, and is imposing arbitrary measures which impact on the delivery of services.
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