The chief executive of Cork University Hospital (CUH) has admitted the hospital is not safe ahead of the coming winter in a scathing letter over recruitment sent to the HSE.

Jennifer Kearney told Priscilla Lynch, integrated healthcare area manager for HSE South West, that the hospital is down 1,050 staff.

“My responsibility as chief executive is not simply to comply with a process," she wrote in a letter first reported on RTÉ radio.

"It is to speak clearly when I believe that process is creating a foreseeable risk to patients and staff.

"I would rather raise that concern now, when there is still an opportunity to act, than remain silent and explain afterwards why we did not.”

Ms Kearney pointed the finger at “increasingly bureaucratic processes” and “a prolonged suppression of recruitment” for the fact that 348 whole-time equivalent (WTE) posts are vacant despite funding for them already secured.

Of the total 1,053 affected posts, a further 249 are approved but unfunded, 202 posts identified in National Service Plans have never been filled, 166 WTE are on maternity leave, and 88 on long-term sickness leave.

"There is a very real danger that we become focused on whether a post has passed through the correct approval gateway, rather than asking the more fundamental question: Is the hospital adequately staffed to provide safe care to patients?" Ms Kearney wrote.

She said services are already reducing capacity, cancelling patients and "relying on expensive temporary solutions".

Ms Kearney has demanded a derogation from the current employment restrictions for CUH and approval of a minimum of 172 priority posts to allow CUH to safely strengthen its workforce ahead of winter.

She said those posts should be drawn from the hospital’s existing list of funded and clinically prioritised vacancies, rather than being treated as new unfunded establishment growth.

“We should not wait for a patient safety incident to demonstrate that the current position is unsafe,” she said, adding that paediatric neurology, radiology, geriatric medicine, endocrinology, and the St Finbarr’s rehabilitation unit are among the areas most affected.

A HSE South West spokesperson said it is working to implement newly introduced employment approval processes and to progress recruitment across all sites.

Meanwhile, the contractor responsible for building the new National Children's Hospital says over 4,600 rooms have been signed off.

BAM Ireland figures show 82 per cent of the total number of rooms are signed off.

The contractor claims almost 700 more rooms are effectively finished and waiting for design team approval.