An outline of the main features of the new hospital consultants' contract to be drawn up by the Government will finally be put to unions representing doctors this week.
The main feature of the document will be the proposal to implement a "public hospital-only contract". This would see consultants working exclusively in public hospitals, for which they would be paid a salary to treat all patients they came across, be they public or private.
The document will also set out the need for consultants to be more flexible and to work in teams around the clock so that patients can be discharged at any time including weekends.
The Government side want hospitals to have a consultant-provided rather than consultant-led service, thus reducing dependency on junior doctors.
The outline proposals are likely to be sent to the Irish Hospital Consultants Association and the Irish Medical Organisation on Wednesday, and face to face negotiations between the sides begin on Thursday.
Already there is disagreement between the sides on how any new deal will be priced, with all sides accepting consultants will have to be paid more for changed work practices. The unions say the deal should be priced at the talks table but the Government side says that when a deal is hammered out, it should be referred to the Review Body on Higher Remuneration in the Public Service for pricing.
Reports yesterday that consultants were likely to be paid a salary of more than €250,000 if they agreed to a public hospital-only contract were said to be "purely speculative" by a source close to the talks.
However, it is accepted that consultants who currently earn an average of €160,000 a year would have to be paid more if they were to forgo opportunities to engage in private practice in public hospitals.
Minister for Health Mary Harney has said she wants agreement on a new consultants' contract by the spring and that if the unions do not accept what is on the table, she will insist on all new consultants being taken on a public-only contract. The unions say they would boycott such a move.
A spokesman for the Minister said last evening that the new contract would be "pro-reform" and "pro-patient" and should not be seen as "anti-consultant". There were a lot of positives for consultants. It would "open up shared appointments and opportunities for part-time working", he said.
Finbarr Fitzpatrick, secretary general of the IHCA, said he agreed to the need for greater flexibility but said this would demand flexibility from other professionals also. On pay increases sought he said: "We haven't put a price on anything yet until we see what are they looking for by way of contractual changes."
He said the IHCA would not be "steamrolled" into a new contract by threats from Ms Harney. "We are prepared to sit down and negotiate as quickly as possible but we are not going to be bullied or browbeaten."
Fintan Hourihan, IMO director of industrial relations, said his union argued for a public-only contract at previous contract talks in 1997.
"The IMO is perfectly happy to see the restoration of this option. However, we do feel that it would be unworkable and counterproductive to insist that it be the only option offered to all new consultant appointments."
Meanwhile, Labour health spokeswoman Liz McManus said there was an urgent need to change consultants' contracts but a public-only contract would create further inequity. Consultants had to be contractually obliged to treat all patients equally, she added, regardless of whether they were public or private.