The head of the Health Service Executive (HSE) says he believes the HSE will face "challenging" cutbacks in the next Budget.
Tony O'Brien says the departure of the Troika does not mean that 'happy days' have returned as the health service undergoes a major restructuring.
He was speaking at a conference on the future of healthcare in Ireland ahead of the announcement of the government plan for universal health insurance.
Tony O'Brien says he predicts that reform of the health sector will take place against the backdrop of "ever-decreasing resources".
It also announced in February that as part of a national review, it is to conduct a review of emergency departments in Dublin.
It is feared this could lead to the closure or merger of some A&E departments around the capital.
The HSE has earmarked 619 million euro in cuts for 2014. And Tony O'Brien says the HSE says there are even more cuts ahead.
"The departure of the Troika does not mean that happy days are here again" he said.
"After an increase in health service resources next year we will face a reduction - so we will have to do all of this at a time of ever-increasing resource" he added.