Pay for new hospital consultants is set to rise to a maximum of €175,000 under proposals issued by the Labour Relations Commission today.
If accepted, consultants will also see the introduction of stricter performance measurement in order to qualify for incremental pay rises.
This would include criteria such as private practice and other work that results in additional income.
Sources said provision for performance measurement already exists, but has never been fully applied.
The Health Service Executive has been unable to fill around 300 consultant vacancies.
The 30% reduction in pay rates for new entrants in 2012 to a scale starting at €106,000 has been blamed.
The Irish Medical Organisation recently rejected the original LRC proposals for a revised pay scale ranging from €127,000 to €175,000 with a 12-year incremental scale.
The latest proposals devised by LRC Chief Executive Kieran Mulvey would see that pay scale retained, but the incremental period to reach the top of the scale would be reduced from 12 years to nine.
The head of a department would earn up to €180,000, while a clinical director's pay would reach a maximum of €190,000.
The LRC recommends that relevant service and specialist training should be considered by a special committee when assessing the appropriate entry point on the scale for new candidates.
Based on such experience, appropriate candidates should be entitled to commence at up to €155,000 - the sixth point on the pay scale - though higher entry may be possible in exceptional cases.
Mr Mulvey recommends that the higher rates should be applied to all consultants who joined the Irish health service since October 2012.
The higher rates would apply from 1 September 2014, meaning those affected would receive back money to that date.
The proposals also address the issue of performance management for consultants, with a recommendation that performance be measured in relation to a number of criteria, including the extent of private practice and other work that results in additional income.
Other criteria include direct clinical care and additional scheduled health service activities, including management or leadership roles, professional activities such as audit, clinical governance, research and appraisal, and external roles in postgraduate training bodies or other groups.
Other factors to be considered would include leave, breaks, travel, cross-cover, and attendance.
In order for a consultant to be eligible for pay progression, each consultant's defined performance targets would have to be signed off by the relevant senior clinical manager and hospital CEO or general manager.
Mr Mulvey recommends that the new evaluation system should be in place by 1 May.
Further talks on the roles and appointment of heads of departments should be completed by 1 February.
Revised pay scales for academic consultants should be addressed in separate negotiations to be concluded by 31 March, with a joint review of the agreement by the end of December 2017.
In concluding, Mr Mulvey stresses that the provisions of the Croke Park and Haddington Road agreements will apply to the proposals and to any measures adopted to implement them.
IMO Director of Industrial Relations Steve Tweed said the IMO had only just received Mr Mulvey's proposals and was circulating them to members.
It expects to commence a ballot on the proposals by the end of the week.
The HSE has welcomed the LRC proposals.
In a statement, it said the proposals agreed between health services management and the IMO represented a positive step forward.
It said the proposal was in its view sufficient to attract the vast majority of the relevant consultants.
It also confirmed that the Irish Hospital Consultants Association, which has not accepted the Haddington Road Agreement, had no involvement in the negotiation.
Sources said it was unlikely that consultants belonging to the IHCA would be placed on the new higher pay rates.
SIPTU, which represents around 40,000 lower-paid healthcare personnel, including porters and health care assistants, has strongly criticised the proposed pay hikes for consultants.
SIPTU Health Division Organiser Paul Bell said he believed there would be a backlash from the lower-paid in the health service, who had what he called a legitimate expectation that any restoration of pay would be targeted in the first instance at staff earning below €35,000 as set out in the Croke Park Agreement.
He said it was absolutely astonishing that such provision could be made for the highest earners in the health service, while at the same time certain management groupings within the health service were pursuing the lower paid for further cuts in salaries through the reduction of premium pay and overtime.
