Hospital waiting lists are increasing and University Hospital Limerick has overspent its budget by over €17m to July, according to latest performance figures from the Health Service Executive.
The HSE currently expects its year-end deficit to be €510m.
The July performance report shows that the number of adults waiting over eight months for a procedure is up nearly 20% and the number of children waiting over 20 weeks is up 16%, compared with the previous month's figures.
The HSE has said some outpatient waiting list targets have been breached by over 300% since January and there are 360,753 people waiting to be seen at a clinic.
While the number waiting over a year to be seen has decreased, there are still over 37,800 patients waiting beyond this period and in a small number of cases waiting over four years.
The July performance report shows there are 54,066 people on a waiting list for an inpatient, or day case procedure - 48,996 adults and 5,070 children.
A further 3,247 people are waiting for a gastro-intestinal endoscopy check, up 20% on the June figures.
The HSE says the number of referrals for planned operations and out-patients has increased, month on month, and the number of patients admitted to emergency departments has also been rising.
The hospitals with the longest adult waiting lists, for inpatient or day case care are: Galway University Hospital with 6,462 patients waiting; Beaumont Hospital Dublin with 5,127 waiting; Mater Dublin 4,594 waiting; St James's Dublin 3,927 waiting; Cappagh National Orthopaedic with 2,823 waiting; and Waterford Regional with 2,571 waiting.
The hospitals with the longest child waiting lists for an inpatient, or day case treatment are: Midland Regional Tullamore with 550 waiting; Galway University Hospitals 362 patients; University Hospital Limerick 337; and Waterford Regional 306.
The HSE says it is preparing an analysis of the growing rates of waiting list target breaches to project extra elective capacity needs but in the context of cost containment.
Comparing July 2014 to July 2013, the number of patients waiting in emergency departments on a trolley for ward bed accommodation is up by 10%.
One factor has been an increase in the complexity of cases attending emergency departments.
Other contributory factors are: continued bed closures this year as a cost-containment measure, refurbishment or cleaning of beds and a rise in "delayed discharges" in hospitals, which now number over 660 patients.
The level of funding to enable these patients to be discharged is not available, the HSE has warned.
The HSE's reported deficit to July is €285m.
Other hospitals that have heavily overspent their budget are: Waterford Regional €8.9m over budget; St Vincent's University Hospital Dublin €8.5m over; Mater Hospital Dublin €7.7m over; Beaumont Hospital Dublin and Cork University Hospitals each over by €7.3m and Letterkenny General €6.9m over.
The HSE's spend on agency staff was €194m to July, compared with €131m for the comparable period last year.
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