Talks between consultants and health service managers aimed at reaching an agreed new contract for hospital consultants were continuing for a second night last night.
Health service management and the Irish Hospital Consultants Association (IHCA) spent most of yesterday in bilateral meetings with the independent chairman of the talks process, senior counsel Mark Connaughton, on arrangements for monitoring a planned 20 per cent cap on private practice carried out in public hospitals.
The Department of Health and the Health Service Executive (HSE) have proposed that this should be based on the case-mix system which measures activity and efficiency in hospitals.
The crucial issue of pay was only expected to be raised in the talks late last night.
Health service management has so far offered salaries of up to €235,000 for consultants opting to work exclusively in the public sector. Sources close to the talks last night said that progress yesterday had been slow.
Yesterday's talks took place only between management and the IHCA, following a decision by the Irish Medical Organisation (IMO) to withdraw from the process in the early hours of yesterday morning.
The IMO is now to ballot its 850 consultant members on proposals for a new contract tabled by management. It is likely to recommend that these be rejected.
It is understood that the IMO was unhappy with a number of management proposals including those for monitoring the private practice cap, arrangements for round-the-clock rosters in some specialties to be decided in local negotiations as well as with rules governing the appointment of new doctors with rights to treat fee-paying patients in off-site private practice.
Some sources said that following the departure of the IMO early on Wedneday morning, there had been some movement by management in areas such as rules for the appointment of new clinical directors, who will head teams of consultants in hospitals in the future.
The chief executive of the HSE, Prof Brendan Drumm, said a huge amount of progress had been made and he remained positive.
He again described the current talks as the final opportunity to reach agreement on a new contract for consultants.
While the IHCA spoke yesterday of "comprehensive heads of agreement", rather than a full contract possibly being concluded in the current round of talks, Prof Drumm said that whatever emerged could not be used "as a platform for further negotiations".
The current process has been running for over four years and health service management has said that if there is no deal reached, it will unilaterally advertise next month for new consultants on revised terms.
The secretary general of the IHCA, Finbarr Fitzpatrick, said that if seven of eight topics were agreed in the current process, then the parties would be well on the way to finalising a contract soon.