In the letter, senior management at Tallaght Hospital, St James’s, the Mater, and Our Lady’s Hospital Crumlin said there was “clear evidence” of patient care being undermined by five years of austerity.
The CEOs described the €206m cuts in their health budgets over the past five years as “shortsighted” and said if they continue, they will “damage the foundation” of the health system.
They warned HSE boss Tony O’Brien that there are not sufficient systems in place to allow the minister to introduce his “money following the patient” model of health funding.
The hospitals had earlier agreed in principal with this funding method.
However, in their letter, seen by RTÉ’s Prime Time, they warned that anybody who suggests the scheme will save “significant” sums of money “clearly misunderstands” the dynamic of hospital management.
Health Minister James Reilly is under pressure to introduce cuts of €666m next year. A supplementary health budget is also looming, with suggestions Dr Reilly could have overspent by €200m.
Mr O’Brien has told an Oireachtas health committee that savings of €1bn would be needed next year, higher than the €666m agreed by the Coalition.