Fewer non-consultant hospital doctors and more consultants were needed in the health services, Minister for Health Mary Harney insisted.
She said the number of non-consultant hospital doctors should be reduced from the current level of 4,000 to 2,000.
"We need to double the number of consultants because it is only when consultants - the key decision-makers - deliver the service, as opposed to leading it, we will get the best outcome for patients and greater efficiency and effectiveness."
Ms Harney was replying to Fine Gael spokesman Dr Liam Twomey who said there should be a new consultants' contract by now which provided for an extended working day and covered issues around on-call and working at night and at weekends.
Ms Harney said there would be agreement "if we threw in the towel and gave everybody what they wanted, which seems to be Deputy Twomey's attitude..."
She said non-consultant hospital doctors got about €200 million annually in overtime for the long hours they worked. "One cannot reduce working hours and pay people the same amount. I do not believe anybody would find that acceptable."
Ms Harney said an analysis was done in nine sites around the country where there was agreement with doctors to do some pilot work around the new working-time directive.
"Unfortunately I understand the Irish Medical Organisation has instructed them not to participate in that process, which is regrettable.
"In the context of that analysis, it was worth noting that 21.9 per cent of the junior doctor's time was spent reviewing a patient already seen by a colleague, while almost 10 per cent of his or her time was spent talking to another clinician."
Dr Twomey said he was not asking Ms Harney to throw in the towel in any negotiations.
"I am asking her to tell us whether she has no hope of renegotiating or has failed to renegotiate consultants' contract, or whether there is some light at the end of the tunnel."
Ms Harney said the process was under way at the Labour Relations Commission. "We have already seen some initiatives, particularly in Blanchardstown hospital where seven new consultants have been appointed."
