Ms O'Byrne has flagged approaching Treasury for more cash, and has already asked the federal government to help out.

Ms O'Byrne said her real worry was a delay between changes being made to the health system and the time it would take for those to affect the state's bottom line.

``Ideally, and everything going well, by the time national health reforms arrive we'll actually have increased output to the level of efficiency we need, which will allow us to grow (services),'' she said.

``The reality is that changing the culture of the way things are done in hospitals takes a long time . . . and the real worry is it will take a little longer than the (national reforms) July 1 date and we'll have to support hospitals through that.''

She said that could involve going cap in hand to Treasury.

``We could legitimately go to Treasury and say: `Here is the evidence that they're absolutely on track to make these efficiencies but this is the way the time period plays out'. I think we could make that case - otherwise they start the new year with a debt.''

Among those at risk is the Launceston General Hospital, which Ms O'Byrne said had chosen to introduce all of its savings in the second half of the financial year.

``It's a little risky as it means that everything has to work, but he (LGH chief executive John Kirwan) is convinced he can deliver.''

She is also waiting to hear back from the Commonwealth on a number of long-term proposals, but wouldn't provide further details.

``Because Tasmania's problem is a broad one . . . (and) our changes are across the entire budget, we've been speaking to both (the federal Health Minister) and the Prime Minister's office about mechanisms that might support us,'' she said.

``Clearly the decision of the Australian government to go into a surplus as quickly as they have is one of the reasons we have less GST, so they're not without some responsibility for the difficulties that we're in and we'll certainly work with them on any opportunity and there are a number of things under discussion.''

Ms O'Byrne said making such health cuts had forced everyone in the system to rethink the way things were done, which would reduce costs behind the system while increasing service delivery.