The HSE has been cracking down on excessive absenteeism among its staff, and has been naming and shaming workplaces where the levels are too high.
This has been in an attempt to lower the organisation’s €248m bill arising from staff calling in sick.
The drive includes targeting sick leave patterns, such as people calling in on days either side of bank holidays.
The four people in the western region were dismissed for repeatedly failing to show up for work because they claimed they were sick.
More than 100 others have been suspended from the sick leave scheme because of suspicions about their behaviour.
Details of the extent of sackings were given at a meeting of the HSE West forum.
The HSE was responding to shock figures which showed that, on average, a total of 132 workers were absent per day at Galway University Hospital and the city’s other public hospital at Merlin Park during 2012.
The figure is 3.79% of the total workforce of 3,479 at the hospitals.
Chief operating officer at Galway University Hospitals, Tony Canavan, revealed that the average rate of absenteeism was dropping but was still short of the national target of 3.5%.
HSE West Forum chairman Cllr Padraig Conneely said he was shocked and disappointed to find that on any one day, 132 staff were calling in sick at the hospitals.
“The fact that there is no need even for a cert from their GP for the first two days is, I think, a little bit rich,” said Cllr Conneely.
HSE assistant regional director of human resources, Francis Rogers, pointed out that 90% of staff who were off sick last year had been certified by a GP.
A procedure was now in place whereby repeated sick leave by any staff member, especially on Fridays and Mondays, was being monitored.
“This can result in the lifting of the sick leave scheme and a requirement for such staff members to provide a sick cert from their GP for every day that they are absent,” said Mr Rogers, who confirmed that four staff in the area had lost their jobs over the last 12 months for bad attendance records.
Despite the crackdown on sick leave in the health service, the figures at specific locations have remained high.
The most recent set of figures supplied by the HSE shows that on average, 5% of HSE workers were out sick on any given day in 2012. However, this was as high as 17% in some divisions.