The Chair of the South South/West Hospital group has resigned, saying 'much-needed reform' has not been delivered.
Professor Geraldine McCarthy's letter to the Minister says they 'are no closer to the required reform than we were six years ago.'
The Group consists of a number of hospitals across the South East including University Hospital Waterford and Tipperary University Hospital.
It comes less than a week after two senior officials from the Slaintecare programme resigned from their roles.
Sinn Fein health spokesperson and Waterford TD David Cullinane feels it is a vote of no confidence in Stephen Donnelly and other senior figures.
"There is a lot of disillusionment among many in healthcare who were expecting reform and wanting to be part of that reform that it is not happening quickly enough.
"It is a vote of no confidence in Minister Donnelly, in the HSE, and the Department of Health Officials at the top," Cullinane said.
"The Minister for Health must lay out a clear strategy for achieving an Irish National Health Service, the departure of the chair of the South/South West Hospital Group follows last week's shock departure by those responsible for delivering Sláintecare.
"These unexpected departures demand clarity on the circumstances surrounding it, and the future of the position." Deputy Cullinane concluded.