Enda Kenny has defended his Government over claims it is sacrificing people's health for a doomed economic strategy.
The Taoiseach admitted the year ahead would be challenging for hospitals and healthcare centres, particularly those carrying over budget deficits from last year.
But he warned there was no point in claiming that difficulties and inefficiencies did not exist.
"We can pretend things are all right, but they are not all right," he said, under questioning from opposition leaders in the Dail.
"We have got to change the structures to make and provide a health system that we believe is in the best interests of our people, young and old alike."
Mr Kenny said more than 13 billion euro had been set aside for the health budget this year while the government was working towards universal health insurance.
"That means focusing now on the provision of primary care centres, where people do not have to go to accident and emergency units in the first place, and where there is clearly an emphasis on community care," he said.
Sinn Fein leader Gerry Adams said the outlook for healthcare in Ireland was "an appalling vista" with Government plans for cutbacks in hospital beds, mental health as well as disability and community services.
"This confirms that the health and the welfare of people is to be sacrificed by Fine Gael and Labour in pursuit of a failed economic strategy that is destroying public services, employment and economic growth," he said.