Nurses fear the HSE’s spending plan poses a “high risk” to the safe delivery of patient care.

The HSE faces significant budgetary pressures in 2018, including having to make savings of €346m, with no contingency fund, and “no capacity” to respond to further pay or other pressures.

Trolley numbers, waiting lists and quality levels will deteriorate across the health service next year despite an “apparent” rise in health spending, the Irish Medical Organisation claims.

The HSE has warned of critical “cost pressures” next year.