Hospital consultants have decided not to co-operate with the implementation of aspects of an agreement reached last week by health service employers with accident and emergency nurses.
Their weekend decision has disappointed SIPTU, one of the unions representing A&E nurses. Its national nursing official, Mr Oliver McDonagh, claimed that the consultants would not jeopardise the deal which ended eight days of industrial action by A&E nurses.
"As far as we are concerned the deal is done and we will not allow anybody to pull that deal from under us," he said.
The national council of the Irish Hospital Consultants Association (IHCA), which met in Dublin on Saturday to consider the implications of the deal, decided to seek an early meeting with the Health Service Employers' Agency (HSEA) to discuss their concerns. The Irish Medical Organisation has sought a similar meeting.
The consultants insisted the decision to admit or discharge a patient was a medical decision that could only be made by a doctor.
The deal reached with nursing unions had proposed a role for nurse bed managers who could cancel planned admissions to ease pressure on A&E and direct consultants to do more ward rounds to try and have more patients discharged to free up beds.
The secretary general of the IHCA, Mr Finbarr Fitzpatrick, said the consultants understood the pressures nurses in A&E were working under and supported their desire to end long waiting times for patients in casualty but they felt bed managers could only discharge patients if the bed managers were doctors.
They also emphasised that elective surgery should only be cancelled in consultation with the patient's admitting consultant. He said "irreparable damage" could be done to a patient's health if the patient's elective admission was constantly being postponed.
"After that, we agree with most of the things the nurses say and want," Mr Fitzpatrick said.
Mr McDonagh last night called on the consultants to work in partnership with the nurses to resolve the A&E overcrowding problem. He said the Nursing Alliance was not suggesting nurses would replace consultants. It wanted senior nurses to be given the autonomy to discharge patients, but only with the consent of a consultant, he said.