The Health Service Executive (HSE) ran almost €25m over budget in January.

The figure comes from the first HSE Performance Review of 2015, which blames the overspend on an "exceptional level" of delayed discharges.

It says hospitals will need to reduce their budgets by a "minimum" of 2 to 2.5% this year to address the deficit in acute services.

The Health Minister Leo Varadkar says the review "demonstrates the scale of the challenge facing the health service".

He says the HSE will examine how to provide "quality services" while at the same time looking for ways to reduce costs.

The report indicates reduced activity in emergency departments compared to this time last year - but notes that there were considerably more older patients with complex medical needs who required longer stays in hospital.

There were 6.8% more emergency admissions aged 65 years and over compared to the same period in 2014.

"2015 was always going to be a challenge and our intensive efforts over the past few months should have some effect, but later in the year," Mr Varadkar said.

"The demographic trends such as ageing of the population that we have identified have manifested themselves in more older people requiring longer stays in hospital."

"There was a sustained exceptional level of delayed discharges in hospitals, maintaining cost pressures on social care services and acute services, particularly EDs. However, agency costs and overtime are not within profile which is of concern."

"On the positive side, we continue to meet our targets for specialist palliative care provided within seven days of referral, for those in inpatient beds and for people in their own homes. We are also largely on target for the number of Home Care Packages and for the number of home help hours provided," he added.