The head of the Health Service Executive (HSE) says he believes the organisation will face "challenging" cutbacks in the next Budget.
Tony O'Brien says the departure of the Troika does not mean that "happy days" have returned as the health service undergoes a major restructuring.
Mr O'Brien was speaking at a conference on the future of healthcare in Ireland ahead of the announcement of the Government plan for universal health insurance.
He predicted that reform of the health sector will take place against the backdrop of "ever-decreasing resources".
The HSE has earmarked €619m in cuts for 2014.
"The departure of the Troika does not mean that happy days are here again," Mr O'Brien said.
"After an increase in health service resources next year we will face a reduction - so we will have to do all of this at a time of ever-decreasing resources," he added.
The HSE announced in February that it is to conduct a review of emergency departments in Dublin as part of a national audit.
It is feared this could lead to the closure or merger of some A&E departments around the capital.