The Irish Nurses and Midwives Organisation has said the HSE’s massive spend on taxis may well be justified.

The Executive is spending €50,000 a day on taxi fares, which works out at more than €16m so far this year.

However, the INMO says many of the patient journeys would be in rural areas where taxi use is most practical.

Deputy General Secretary, Dave Hughes, said: “I think the figure looks pretty shocking when you put a four-year figure of €90m, it looks like an awful lot of money spent on taxis.

“My instinct would be that the health service legitimately incurs a lot of taxi fares because of the rural nature of a lot of their services.

“So there could be taxi fares which will work out cheaper than providing their own transport to go in and out.”