A special delegate conference of the Impact health worker union has voted for strike action unless the Health Service Executive restores what it describes as lost confidence in the health reform programme.
At the conference in Dublin today, 250 delegates unanimously supported calls for work stoppages within the next three months unless the HSE dramatically changes.
The union plans to ballot all 27,000 members for strike action in May if its grievances with the way the HSE is being run are not resolved.
If it is supported it could leave the health service trying to survive without nurses, who have three stoppages planned for next month, and also ordinary clerical staff who run hospitals and clinics on a day to day basis.
Kevin Callinan, national secretary of the union's health and welfare division, said employees were trying to hold the service together, and improve it, under increasingly difficult conditions.
He said the decision to create the HSE and give it total control of health care in 2005 had been rushed.
"Everyone working in the system — and we as your representatives — have experienced the chaos, confusion and creeping demoralisation that has followed as a direct consequence," he told the conference.
"The Government's sole focus — its obsession — with administrative reorganisation and high-cost consultants has nothing to do with creating an excellent, fair and cost effective public health service.
"It is a damaging proxy for real reform."
IMPACT officials said workers were frustrated by the failure to deliver a fair health care system, despite the Government's promises, frustrated at the criticisms levelled at them that they are not doing their best and the focus on privatisation. It is the second ballot which has threatened the health service in as many weeks.
Today's conference comes just days after the Irish Nurses Organisation and Psychiatric Nurses Association voted to walk out at major hospitals in coming weeks over unsatisfactory working conditions.
Taoiseach Bertie Ahern has said their pay claim could cost €1 billion.
Lunchtime protests will take place next month at Cork University Hospital, University Hospital Galway, the Mid-Western Regional Hospital, Co Limerick and the Mater Hospital, Dublin.
IMPACT, which represents a wide range of workers including nurses, therapists, clerical and administrative, IT and accounting staff, will now put the plan for strike action to members up and down the country. The union is due to hold its health biennial conference in Portlaoise in three months.
Mr Callinan also described a demoralised staff, working in a frustrating and uncertain environment.
In response the HSE said it was carrying out an ambitious reform programme. "Staff at all levels have a responsibility to implement this significant change programme. The change that is required is designed to benefit patients across every aspect of the system," the HSE said.
The body said it anticipated hiring a further 4,000 workers this year and that employment in the health service grew by over 7,000 in 2005 and 2006. Martin McDonald, HSE national director of human resources, said: "Any suggestion regarding staff cuts is quite obviously incorrect."
The HSE added: "With regard to the appointment of external advisors: Such appointments are a feature of many aspects of the public sector where the use of outside expertise — from time to time — is considered an effective component.
"With regard to the creation of the HSE, it is recognised that IMPACT negotiated a framework agreement for members at the time and that the HSE continues to adhere to the terms of this agreement. "There is a definite imperative for change to allow for the creation and delivery of a world class health service. The need to achieve this efficiently and speedily is well recognised and the HSE is committed to delivering on such change."