Hospital consultants have begun talks at the Labour Relations Commission on changes to work practices and new productivity measures.

Earlier, the Irish Hospital Consultants Association was summoned to a meeting with top health officials where they were warned that there would be consequences if they did not attend.

The consultants had previously failed to give an indication they would attend the talks on introducing measures including a 24- hour roster pattern, the creation of a lower entry grade pay level for consultants and changes to allowances.

However, following the meeting with health officials, the consultants agreed to enter tonight's discussions.

The Health Service Executive and the Irish Medical Organisation had already agreed to attend.

Much of the initial discussion however, is expected to centre on whether or not any agreement reached is binding.

IHCA secretary general Martin Varley said the organisation was committed to the Croke Park Agreement and over the past 18 months had "worked with the State and the department in already delivering huge improvements on behalf of patients and giving rise to huge savings".

The HSE has said that getting consultants to work over a 24/7 schedule is central to securing efficiencies and savings in the health service.

It also wants consultants to work to a new clinical director grade and to cooperate with the introduction of a lower-paid level one entry grade for consultants.

The HSE is also seeking reductions in allowances for consultants.

However, consultants have argued that a number of items sought by the HSE are not covered by the Croke Park Agreement.