The Health Service Executive has confirmed there will be a 30% reduction in the starting salaries for new consultants.
It follows the conclusion of talks involving the Irish Hospital Consultants Association, the Irish Medical Organisation and the HSE at the Labour Relations Commission.
HSE National Director of Human Resources Barry O'Brien said the new salary rate for consultants would be between €116,000 and €121,000.
Mr O'Brien said consultants did not agree with the new rate but they were aware of the HSE's decision to proceed with it and implement it.
He said new consultant posts would be advertised at this rate, which represented a €50,000 saving per consultant post.
Consultants have agreed to present compromise proposals on reforms to their members for consideration.
It is understood the document includes proposals to fully resolve issues around rosters and the reporting relationship with clinical directors.
However, two issues will be referred to the Labour Court for binding adjudication under the Croke Park Agreement.
Those issues centre on mental health services and arrangements for consultants' rest days in the future.
The issue of historic leave for consultants will be referred to the Labour Court under dispute resolution mechanisms rather than under the Croke Park system.
IHCA Secretary General Martin Varley said the proposals should give rise to a significant increase in productivity.
He said the overall outcome of the talks means that consultants will be in a position to continue to treat more patients in hospitals despite the financial pressures facing the country.
Speaking on RTÉ's Morning Ireland, Mr Varley said there was no agreement on the issue of a new consultant grade and it was not provided for under the Croke Park Agreement.
On the issue of rest days for consultants in the future, he said the HSE was proposing to reduce rest days to two days off for a consultant who was on call every day, night and weekend for a four-week period.
He said the IHCA could not agree to that as it did not make sense for a consultant to be on call for a full 26 days out of 28.
The Irish Medical Organisation will also present the proposals to members for consultation.
It is not yet clear when the consultation process will be completed or when the referrals to the Labour Court will take place.
James Reilly welcomes agreement
Minister for Health James Reilly said the consultants' organisations have shown considerable leadership in agreeing to recommend the changes.
He said agreement will give all the flexibility that has been sought by the HSE.
Mr Reilly said that new rostering agreements, especially, would save over €200m a year.
He said consultants could now be rostered from Monday to Monday, instead of just Monday to Friday, and could also be rostered through the night.
The minister said: "It'll reduce hugely the premium pay bill, the overtime bill.
"It'll also mean more consultants on at night, so less [sic] junior hospital doctors at night; less [sic] tests being ordered, I would imagine, because more decisions will be taken more quickly and we will get much better use of beds."
Mr Reilly said that the agreement had wider ramifications in that the HSE will now be looking to other healthcare professionals to match what the consultants have done.
Me Reilly said the previous consultants contract, which was agreed in 2008, contained much aspiration but delivered little.
He said consultants who operated under clinical programs had in recent times changed their work patterns and there had been a lot of change on the ground.
But he said such change could not just happen on a pro-bono basis, and after progress had not been made under the Croke Park agreements he was pleased that progress had now been made under the auspices of the Labour Relations Commission.
He said Clinical Directors would now have responsibility for medical manpower budgets and rostering and would now be able to manage both NCHDs and consultants, who would now work at night and at weekends.
