Health service management has signalled that it is prepared to pay public hospital consultants up to €230,000 per year in a bid to clinch a deal on a new contract.
It is understood that management is also prepared to offer some increase in the number of new consultant posts with rights to treat fee-paying patients in off-site private hospitals.
Previously, management had said that such type C posts could be established only in exceptional circumstances.
However, sources said that management had now signalled to the consultants' representative organisations, through the independent chairman of the process Mark Connaughton, that there could be a slightly more expansive number of such positions.
Mr Connaughton discussed the new proposals with medical organisations last night.
It is expected that there will be intensive contact between Mr Connaughton and the various parties over the coming days in a bid to see if progress can be made before a deadline set by the Government effectively expires at the end of the week.
The Minister for Health, Mary Harney, said the current process to negotiate a new contract for consultants, which has now been under way for four years, must end by Christmas.
She has signalled that if there is no agreement by the deadline, management would move unilaterally to advertise for new consultants on revised terms and conditions.
Despite all sides accepting the broad principles of a new contract, set out in a report by Mr Connaughton in early October, there has been no agreement between the parties on a number of crucial issues such as pay, private practice rights and hours of work for some doctors.
The new pay offer represents an increase of more than 6 per cent on the €216,000 maximum scale offered previously by management.
It is understood that the €230,000 would be offered to consultants prepared to take the type A contract which would see them work exclusively in public hospitals with no private practice.
This figure would be discounted for the other types of contract which would allow for various forms of private practice.
However, management has not put forward a final salary scale for the different types of contract on offer. Consultants opting for a type B contract, which would allow for limited private practice in public hospitals and in new co-located private facilities, had previously been offered €175,000-€190,000.
About 700 consultants who currently have rights to treat fee-paying patients in off-site private hospitals would be allowed to continue with these arrangements if they sign up for the other elements of the proposed new contract such as working as part of teams over an extended day.
They had previously been offered salaries of €156,000-€171,000.
However, one of the main sticking points in the talks has been whether consultants appointed in the future should also have such rights to work in off-site private hospitals.
Management had initially said that no new consultants would have such rights. However, that position has evolved over recent months. In October, management accepted proposals drawn up by Mr Connaughton which allowed for the establishment of type C contracts in exceptional circumstances.
It is understood that in its new proposals, management has insisted that there will not be quotas for these type C posts but has proposed that a new group with a strong public interest representation should be established to set criteria for these positions and to regulate the area.
It is expected that management will want a definite indication from consultants in the coming days as to whether both the pay offer and the principle of a cap of 20 per cent on private practice in public hospitals are acceptable.
Management will also be looking for an assurance that the medical organisations will agree to a mechanism for enforcing these restrictions.
Management has said that it is open to discuss ideas for an appropriate mechanism to ensure compliance with the cap.