Management in the health service is seeking to introduce a general provision requiring staff to co-operate with outsourcing as part of new reforms under the Croke Park agreement.
Unions are expected to resist the move in a response document to be tabled next week.
In a letter to the Croke Park implementation body dated November 2nd, the secretary general of the Department of Health Ambrose McLoughlin said such proposals were currently being developed in a process involving the HSE and the Department of Public Expenditure and Reform.
Dr McLoughlin said that as there had only been a limited time for consultation with unions, the revised action plan was being submitted as a management document.
The management document said the key requirements of the HSE's service plan for next year were likely to include measures to achieve significant spending cuts and substantial reductions in staff numbers, as well as "more cost-effective provision of public nursing home services as alternative to contractions in capacity".