The Health Service Executive (HSE) has fined the country's acute hospitals more than €3.7m for breaching waiting list targets for the last five months of 2015.
A report in the January edition of the Health Manager Journal says the fines have been levied on hospital groups, rather than individual hospitals.
The targets state that nobody should wait more than 18 months for hospital treatment.
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However hospital managers say the main reason they fail to meet targets is lack of resources.
Meanwhile, it is not clear if the fining scheme will continue into 2016.
The hospital groups were fined €752,301 for December 2015, €1.236m for November, €1.649m for October, €1.666m for September and €1.158m for August.
