The government has given approval for talks which could see the appointment of hundreds more hospital consultants, with outpatient clinics operating from early morning to late evening.
The talks, on proposals in the report of the Medical Manpower Forum, could also result in nurses treating certain patients.
First, however, there will be months of tough negotiations with health-service unions. The cost of the measures will run to hundreds of millions of pounds as non-consultant hospital doctors are replaced by consultants.
Last night the first shots in the negotiation battle were fired when the Irish Medical Organisation said it would not accept some apparent reservations by the Government regarding the cost of the proposals. But the Irish Hospital Consultants' Association welcomed the negotiations.
The Government also agreed to set up a task force to work out how to reduce the working hours of non-consultant hospital doctors to 58 hours by 2004 and to 48 hours by 2010.
The Minister also announced yesterday the start of work on a new national health strategy which will outline the overall direction of the health service until 2008. The public and all interested organisations are being asked to tell the Department of Health and Children what the strategy should contain.
The strategy document would be published in July, the Minister said. It will be produced by a "project team" chaired by one of the Department's most senior and experienced civil servants, Ms Frances Spillane.
As well as announcing agreement to the start of negotiations on the issues, yesterday's statement from the Minister said that the Government noted the recommendations in the Medical Manpower Forum's report and "will consider these proposals again in the light of the results obtained from a costing study on the matter". It was this apparent reservation which angered the Irish Medical Organisation.
A pilot study will be carried out in six hospitals to examine the implications of implementing the forum's proposals. The Minister said yesterday that he expected this study and the negotiations to take eight or nine months.
Mr Finbarr Fitzpatrick, secretary general of the IHCA, said it was important that the negotiations be finished this year.
Information on the discussions on a new health strategy and on how to contribute to it are on the Department's website at www.doh.ie