The employment of hundreds of extra consultants to boost the quality of hospital services has been recommended in a report to the Government.
The cost of implementing the report - being brought to the Government by the Minister for Health and Children - could be over £500 million per annum.
The report, which has been seen by The Irish Times, will be published shortly. If implemented, consultants will be present in hospitals 24 hours a day, seven days a week. Patients will be more likely to be seen by a consultant and extra clinics will be held outside normal working hours.
The proposals were drawn up by the Medical Manpower Forum, which includes the major bodies in the medical sector including the Department of Health and Children, the Irish Medical Organisation, the Irish Hospital Consultants' Association and the teaching and regulatory bodies.
It will take some years to implement as it will require detailed negotiations with medical, nursing and other health service trade unions. But work has already begun on choosing a small number of hospitals in which the proposals will be put into practice experimentally for about six months.
The report makes it clear that the forum is dissatisfied with the service hospital patients receive. Too many are treated by doctors in the early years of training, it complains, and training is not as good as it should be.
More consultant posts and better training would keep Irish doctors in the hospital system who leave to go abroad because of too few promotional opportunities here. While the report does not say how many extra consultants should be appointed, it draws a comparison with the Scottish health service, saying we would need an extra 630 consultants to put ourselves on a par with that system.
The report also does not include costings. However, the Minister, Mr Martin, recently told Mr Michael Noonan TD in a Dail reply that the cost of employing one extra consultant with drugs, staff and support services is about £800,000 per annum.
The report, if implemented, would mean patients could go to outpatient clinics in the evenings or early morning as well as during the day. Consultants would order fewer tests than partially trained doctors and could make decisions reasonably quickly, cutting down on waiting times.
There would also be more women consultants - the report is strongly critical of the failure of the hospital system to appoint more women doctors as consultants and recommends measures to change this.