The HSE could need a Government 'bail-out' of over €200 million at the end of the year, latest figures have indicated.

And the HSE has told hospitals to make additional cost-cutting measures by the end of the year to cut their growing deficits.

Meanbwhile, latest HSE stats also show that the number of people with full discretionary medical cards has dropped while the numbers with discretionary GP visit cards has increased over the past year.

The latest monthly performance report from the health executive shows that on a day-to-day spending basis, the gross deficit on its spending is €93.7 million at the end of August, compared to a deficit of €404 million at the same time last year.

The HSE has projected that this deficit could reach around €105 million at the end of the year unless additional savings are made.

In addition, the HSE has no contingency funds to cover issues such the shortfall of around €60 million due to the delay in implementing new private bed charges and the shortfall in projected pay savings under the Haddington Road agreement.

While the end-of-year outturn for expenditure is not yet known, these funding pressures could push the HSE's end of year deficit to over the €200 million mark.

Meanwhile, hospitals, some of which are running up large deficits, have been told by HSE Director General Tony O'Brien to take action to cut these deficits by the end of the year.

HSE Deputy Director General Laverne McGuinness told a press briefing today that hospitals had been asked to deliver on their cost-containment plans that they would have drawn up at the beginning of the year.

She said the HSE was not asking hospitals to cut back on their activity levels, but was targeting areas such as overtime and agency costs and levels of discretionary expenditure.

Latest HSE figures show that St James's Hospital has a €10.3 million deficit, St Vincent's has a €8.6 million deficit, University Hospital Galway is €7.2 million over budget, while Cork University Hospital is €6 million in the red.

Latest figures also show that there are 8,244 people waiting over three years for a hospital outpatient appointment, while 20,501 are waiting between two and three years and 55,422 are waiting between a year and two years for an appointment.

In spite of the high number of people on long outpatient waiting lists, the HSE still says hospitals will be working to ensure no patient is waiting more than 12 months for an appointment by the end of the year.

There are currently nearly 58,649 adults and children on waiting lists for hospital treatment, including 6,666 waiting over eight months for treatment.

Recent figures from the National Treatment Purchase Fund (NTPF) showed  that the number of patients waiting over nine months for treatment increased by 115% in the 12 months to August 2013.

Latest HSE figures also show that while the number of people covered by full medical cards has increased by just over 9,000 since the end of last year, the number of people holding GP visit cards has dropped by 6,700.

The number of full medical cards granted on discretionary grounds has dropped from 63,126 at the end of last year to 53,888 at the end of August.

The number of GP visit cards granted on discretionary grounds has increased from 15,833 to 21,132 in the same period.

This indicates that many patients with full discretionary cards have had their entitlement downgraded to a GP visit card over the past year.

A full medical card provides for free GP visits and medicines, whereas a GP visit card just covers the cost of a GP consultaiton.