Hospital consultants have broadly welcomed the majority of recommendations in the Brennan Commission report as published in yesterday's Irish Times.
The Irish Hospital Consultants' Association (IHCA) said it "particularly welcomes the proposal that the patient should be the cost base at the centre of our health services".
The association's secretary general, Mr Finbarr Fitzpatrick, said he also welcomed the proposal to reduce the number of health boards and other health service agencies.
However, the IHCA said it does not accept the recommendation that a "public only contract" should be obligatory for new consultant appointments.
Mr Fitzpatrick told The Irish Times the association had no problem with such a contractual change in principle, "but only if it is available to everybody, as a choice for all consultants".
He added that "the Irish Hospital Consultants' Association is available to discuss amendments to the common contract, including greater flexibility which the association actually proposed to the Department of Health in September 1999".
Mr Fintan Hourihan, director of industrial relations with the Irish Medical Organisation, said it would not agree to a mandatory "public only" contract for hospital consultants.
He also said that if what was being proposed by the Brennan Commission placed a doctor's clinical autonomy under threat, this "would be anathema to the medical profession".
He noted that the Irish Medical Organisation was "willing and available" to enter into negotiations on a new consultant contract 18 months ago.
In a general comment on the commission's work, Mr Hourihan said there was some concern that it amounted to "a scapegoating exercise to hide the deficiencies of those who should be managing the health service in the first place".
Dr James Reilly, chairman of the IMO general practitioners' committee, said the commission's contention that the medical-card scheme represented one of the biggest financial risks to the health service nationally was "extraordinary".
"How could a scheme that looks after a third of the population and is responsible for less than 12 per cent of health service expenditure be so labelled?" he asked.
In a reference to proposals to make family doctors responsible for practice budgets, Dr Reilly said it suggested a desire to see general practitioners turn into "mini-accountants for the business of government. The doctor-patient relationship is sacrosanct and any attempt to undermine it will be strongly resisted," he said.
A spokeswoman for the Irish College of General Practitioners said it wished to reserve its position until such time as the commission's report was formally published.