Medical consultants will lose their veto on appointments of new colleagues following the absorption of Comhairle na nOspidéal into the proposed Health Service Executive (HSE).
Comhairle na nOspidéal, which is chaired by Cork University Hospital consultant geriatrician Dr Cillian Twomey, has been accused of restricting the entry of new consultants.
Under the Government's plan, the statutory council, which regulates the number and type of consultants appointed and lays down the qualifications they need, will become part of the HSE's National Hospitals Office (NHO).
During the formal launch of health reform programme on Wednesday, the Government said the body would be one of the agencies to be "subsumed" into the HSE.
However, The Irish Times has learnt that the 27-strong council, which is dominated by consultants, will not continue to meet to carry out its functions under the new body's umbrella.
Once in place, the director of the NHO will decide on new appointments having taken "the advice of medical experts", though the final decision will be the director's alone.
"You can't make decisions like this without medical advice, but it will be advice not vetoes," one Government source close to the reform package told The Irish Times last night.
Comhairle na nOspidéal, which recently called for a doubling in the numbers of consultant numbers, has consistently rejected charges that it has restricted entry.
In 1990, 1,122 consultants of all types served in hospitals in the Republic, though the number has grown to 1,731 today, according to January statistics from the body.
However, it has been blamed for not focusing sufficiently on specialities such as dermatology, rheumatology, and for wanting to concentrate resources in major hospitals.
Last year, management experts Indecon reported that it took on average 1.5 years for a health board to fill a consultant post through the Local Appointments Commission.
This appeared "inordinate compared with most other public sector appointments, and particularly compared with the norms prevailing in the private sector", said Indecon.
Expressing concern about the structure of comhairle, Indecon said the board's composition "could potentially result in bias" towards maintaining existing number, rather than reflecting the demand for specialists.
Comhairle, it went on, should have a consumer/patient representative. Currently IMPACT assistant general secretary Ms Christina Carney is the only non-medical, non-health service representative on the board.
The Hanly Report, the latest draft of which has been seen by The Irish Times, has called for a major increase in the number of consultants.
Like the Brennan Report, Hanly favours a consultant-provided service, with consultants available in hospitals on a 24-hour basis, though consultants would do less nights the more senior they became.