The Health Minister Simon Harris has survived a no confidence motion in the Dáil.
The vote broke down as 53 in favour, 58 against with 37 abstentions.
TDs Denis Naughten, Noel Grealish and Michael Lowry voted with the Government.
There was an initial discrepancy over how many abstentions there were - but following a walkthrough vote at the request of Sinn Féin, the final numbers were confirmed.
Final vote after walkthrough:
In favour 53
Abstain 37 https://t.co/p0fuZgEKBi
— Seán Defoe (@SeanDefoe) February 20, 2019
Sinn Féin had submitted the motion over Mr Harris’ handling of cost overruns at the new National Children's Hospital.
The motion had the support of Labour, the Green Party and a range of independents - including the chair of the Oireachtas Health Committee, Dr Michael Harty.
However, Minister Harris had been expected to survive the vote, after Fianna Fáil has indicated it would abstain.
In defence of Mr Harris, the Taoiseach Leo Varadkar said: "Without doubt, being minister for health is one of the toughest briefs in Government.
"I believe it is one of the most important jobs in the country because it affects so many lives".
"I have confidence in the minister for health for many reasons.
"He's a minister who's getting things done: a successful referendum on the eighth amendment, a public health alcohol act, and, after years of little investment, three new national hospital projects now under construction and a fourth due to go to tender in the foreseeable future."
"Even in the toughest of areas, like the number of patients on trollies, he has made measurable progress.
"While still far too many, this year so far it is the lowest in three years and in January the number of patients waiting more than three months for an operation or a procedure - the Sláintecare target - was at a four year low.
"We've lost some ground due to recent strikes but we will regain that ground."
He added: "It is easy to throw rocks. It takes courage to put your reputation on the line and try and build something better and something lasting.
"Minister Harris has the courage and the competence to succeed as Minister for Health. He deserves our support."
But in the debate ahead of the vote, a number of opposition TDs sharply criticised Fianna Fáil.
Sinn Féin's health spokesperson Louise O'Reilly claimed there will not be results by keeping the current health minister in place.
She also described Fianna Fáil as "opportunistic cowards" for their decision to abstain.
Ms O'Reilly said: "The simple fact is that nobody can defend it - no one except you and the opportunistic cowards in Fianna Fáil".
"The submission of this no-confidence motion was not rushed, it is not vindictive or personalised, this motion was submitted because the scandal of the National Children's Hospital overspend was the final straw.
"There are those out there in your own party and in the media that somehow think that this motion is unfair.
"When I hear that I wonder if these people have lived under a rock for the past three years, are they being deliberately obtuse, or just plainly partisan.
"Those who say this motion will not build a hospital or reduce waiting lists, nothing this Government is doing is currently achieving that either."
"Past performance is, I believe, an indicator of future performance," she told Minister Harris.
Labour's health spokesman, Alan Kelly, said he did not blame Mr Harris for his position.
"This is not personal towards Simon Harris who as an individual I would consider to be very honourable and fundamentally decent.
"However, the situation we have in Irish politics at this moment in time is intolerable and the situation we have in health is the greatest example of it.
"It's intolerable for everyone - the Government, opposition and indeed the public."
"To be fair, Minister Harris has had some successes in his ministry and the legislation to repeal the eighth is an obvious example.
"That was a notable achievement and one that you should rightly always have beside your name.
"Furthermore the reform of the HSE structures are absolutely necessary and the way in which it was structured by multiple ministries simply needed complete overhaul."
"Colleagues, I'm sick and tired of people referring to the Department of Health as Angola and that every minister that goes in there just tries to live to see the day when they will get out. That should not be the case.
"Bad politics has destroyed the Ministry of Health. Bad politics of 30 years has turned the department into the ministry the Taoiseach of the day gives to his pupil who he needs to bring down a peg or two".
Bring it on! We’ve worked together to repeal the 8th, pass the Public Health Alcohol Bill, help our CF patients access new medicines, introduce the HPV vaccine for boys & develop a cross party 10 year plan to reform our health service. So much more to do! Looking forward to it pic.twitter.com/ebaqGXwy2Y
— Simon Harris TD (@SimonHarrisTD) February 20, 2019
Referring to a tweet Mr Harris sent on Wednesday morning, Mr Kelly said: "I say this quite openly we really need to grow up as a political institution in how we manage the politics of health and your tweet this morning minister 'bring it on' wasn’t wise. It did nothing for you minister.
"30 years of continuous policy change and counter change and inconsistency in approach and political arse covering has not served the people well.
"And I say that acknowledging that there are so many good people at high levels in the HSE and the department who work extremely hard.
"However if it was possible, Minister Harris, the department of health and the HSE has turned into an even bigger disaster zone during the last three years. I could speak for hours on hundreds of issues."
The projected cost of the children's hospital project has spiralled to at least €1.7bn over recent months - up from an original estimate of €650m.
This motion of no confidence was the third the Government has faced since Leo Varadkar was confirmed as Taoiseach.
The Housing Minister Eoghan Murphy survived a vote in September, while Frances Fitzgerald resigned as Tánaiste and Business Minister hours before a motion came before the Dáil.
Additional reporting: Sean Defoe