The chief executives of four of the country's largest hospitals have written to the HSE Director General warning that cuts in funding and rising demands for patient services, have begun to seriously threaten the quality and safety of patient services.

The letter was sent to Tony O'Brien by the chief executives of St James's Hospital, the Mater Hospital, Tallaght Hospital and Our Lady's Children's Hospital in Crumlin.

The hospital chiefs state that it is inherently contradictory to ask them to reduce waiting lists and staff numbers, while at the same time guarantee safe services to patients.

They said there have been 'unacceptable delays' in treatment access for some cancer patients due to overwhelming pressure on services.

The chief executives said the 'short-sighted random application of budgetary reductions' is likely to seriously damage the foundation of the health system and the current budgetary approach was unsustainable. The letter was revealed by RTE's Prime Time.

A spokesman for the Minister for Health said Dr Reilly would not be responding to its contents.

The latest development comes as hosdpitals are awaiting news of further budget cuts next year in the HSE's 2014 servive plan.

Over one-fifth of the health service budget has now been cut since 2008.

Hospital chief warns on further cuts

Reilly under pressure