The Health Service Executive (HSE) will go ahead unilaterally and advertise for new medical consultants on revised terms and conditions next month if there is no agreement at crunch talks on a new contract for senior hospital doctors which get under way today.
The HSE would in effect reactivate a controversial competition for 68 consultant posts on revised pay and conditions which was suspended last year.
The Government has signalled that today's talks will be the final set of negotiations on a new contract for hospital consultants, a process that has been going on for four years. If there is a deal reached, the HSE will seek to appoint dozens of additional consultants in the weeks ahead on terms agreed with the medical representative organisations.
However, The Irish Times understands that the Minister for Health, Mary Harney, instructed the HSE just before Christmas to draw up a contingency plan for appointing new consultants in the event that a deal is not concluded with the medical bodies.
It is understood that under this plan the HSE would place advertisements next month for additional consultants to be recruited on revised terms.
It is expected that in this process priority would be given to recruiting consultants in the areas of cancer, maternity services, neurology and mental health.
In addition, the HSE plans to set a closing date for applications for 68 consultant posts that were advertised last spring. This competition was suspended after the general election last year without a closing date for applications being set or interviews of candidates being held. The suspension of the competition was aimed at facilitating further talks between health service management and medical organisations.
It is understood that in its contingency plan, the HSE has also drawn up proposals aimed at bypassing any boycott of the recruitment process for new consultants that could be put in place by medical organisations.
The Irish Medical Organisation and the Irish Hospital Consultants Association have said that they would not co-operate with the recruitment of new doctors on terms put in place unilaterally by the HSE.
It is understood that under its contingency plan the HSE would initially seek Irish consultants to participate in the process of shortlisting candidates and serving on interview panels. If this is not possible, the HSE would move to engage external recruitment consultancy services who could source relevant medical expertise abroad.
The management side at the talks today will be headed by the secretary general of the Department of Health, Michael Scanlan, and the chief executive of the HSE, Prof Brendan Drumm.
Sources said both men would remain at the talks until there was a deal or it was apparent the process had broken down.
It is understood that the chairman of the talks process, Mark Connaughton SC, in a letter to the parties last week identified a number of areas on which there is still no agreement.
These include pay, private practice rights including measures to enforce a proposed 20 per cent cap in public hospitals, hours of work, disciplinary procedures, the appointment of proposed new clinical directors and the structures of a new body to regulate consultant appointments.
The IHCA last night said it was entering the talks with a degree of hope rather than optimism. The IMO said it would engage constructively but at this stage there did not appear to be great grounds for optimism.
The introduction of a new contract for hospital consultants is one of the key elements of the Government's overall healthcare reforms. However, the process has been beset by rows and missed deadlines.
Today's talks represent the fifth deadline set for completion of the process over the last year or so.
Health service management has offered salaries of up to €235,000 for consultants who take the new contract. However, medical organisations have argued that further down the scale, some consultants would receive no increase in salary when account was taken of the additional hours of work involved.