Dozens of consultants have been offered positions in the health service, but with no start dates due to financial overruns and recruitment controls, a representative union has said.

The Health Service Executive has been under significant financial pressure in recent months, with the figures up to the end of July showing a €577.9 million deficit.

Chief executive Anne O’Connor took steps to ameliorate the position at the end of April by placing three regions – Dublin and South-East, Dublin and Midlands, and the South West – in what is known as tier-three escalation, which introduced employment controls and greater scrutiny on spending.

The move did not make sufficient progress on the overruns, with Minister for Public Expenditure Jack Chambers on Thursday stating four of the six regions have had their day-to-day spending autonomy stripped.

The Irish Hospital Consultants Association (IHCA) expressed concerns about the impact of the financial controls on staff.

A spokeswoman said the association was aware of dozens of consultants who have been offered positions but have not been given start dates, with this being “most prevalent” in the regions placed in tier-three escalation.

However, she said there are “recruitment problems” countrywide.

“For example, one consultant returned home to Ireland from Australia to take up a permanent position in the west four months ago with his wife and young children, having accepted a permanent replacement position due to commence at the end of July,” she said.

“The family is now living in rented accommodation without certainty as to when the HSE will honour the appointment.”

The IHCA said no health service can “expect to recruit and retain highly qualified specialised doctors and other healthcare workers while treating them in this manner. The concern is that this could do irrevocable damage to the reputation of the HSE and impact on recruitment for years to come.

“The additional financial controls are also forcing existing staff to try to maintain increasingly fragile services in the face of ever-increasing demand for hospital care.”

The IHCA also said it has “long advocated” for devolved, localised decision making, but said it had warned that the current restructuring added layers of bureaucracy and that it would result “in a poorly integrated system”.

Irish Medical Organisation chief Matthew Sadlier said the union is “extremely concerned” by comments from the Minister.

“We have a growing and ageing population which requires a realistic budget to match the needs of the population and to enable the move towards a service that enables clinicians to deliver timely and appropriate care,” he said.

“Issues around governance of the regions are one thing and should be resolved; however, the broader issue of inadequate budgets is the sole responsibility of Government.”

On Thursday, Minister for Health Jennifer Carroll MacNeill said the measures taken over recent months to control the growth in expenditure had not had sufficient impact to date.

“My focus is on maximising this significant extra investment by the taxpayer across all services to ensure patient safety and access to care for all,” she said. “This must be done by doing better with these resources and spending breaches in areas where control is possible are not tenable.”

Opposition politicians have criticised the U-turn on devolved funding, noting restructuring of the health service as a key part of the Sláintecare reforms. They called for “realistic” budgets to be provided to the service.

The HSE was contacted for comment.