Taoiseach Enda Kenny has said reform will have to accompany any further funding of the health services.

He said €13.6 billion was being allocated this year.

“I have no intention of going back to a situation where endless money was thrown at the health system without reform and effective spend for the taxpayer, and particularly the patient, to get the very best outcome for them,’’ he added.

Mr Kenny said it was not satisfactory to have elderly people waiting on trolleys for a long time, as well as incidents which should not arise in hospitals. Without effective reform, it could always be said there was not enough money for the health services, he added.

He was replying to Fianna Fáil leader Micheál Martin, who said the Government had approved a plan which left acute hospitals short by €100 million. He predicted there was "real trouble'' ahead this year for hospitals.

There would, he added, be more overcrowding, longer waiting times and higher waiting lists. He accused the Taoiseach of consistently underfunding health.

Mr Kenny said while capacity was up by 5 per cent this year, so too was the number of visits and calls to accident and emergency units.

He said 1,000 beds had been taken out of the system. There were 750 more nurses and 300 more consultants and doctors employed since 2011, he added.

“There is an increase of €800 million in the spend for this year,’’ he added.

Mr Martin claimed there had been three “fraudulent budgets’’ for health over three years. He added the Taoiseach could not come into the Dáil and talk about the need for reform, because he had promised it for five years under the name of universal health insurance and ditched it at the eleventh hour.

“He is afraid even to talk about health in public,’’ he added