The Department of Public Expenditure and Reform, and not the Department of Health, is dictating the delivery of healthcare in Ireland, according to the outgoing president of the Irish Medical Organisation.

The Government has defended settling a claim that will see hefty pay awards for thousands of hospital consultants at a time when 707,000 patients remain on waiting lists.

A €40m plan to deal with the anticipated surge in hospital activities over the winter has been described as a “drop in the ocean” by doctors at a time when operations are already being cancelled and daily trolley figures frequently exceed 400.