Hospital consultants have warned of possible industrial action over the two-tier pay system introduced in 2012 for new entrants, which can see doctors doing the same work earning €50,000 a year less depending on when they were recruited. 

The Irish Medical Organisation is to carry out a survey of consultant members to establish what level of industrial action they would be prepared to take in order to see the restoration of pay equality. 

During the economic crisis, the Government cut the pay rates for new recruits across the public service by 10%. Seven years on, government employees doing the same work can be on significantly lower remuneration depending on when they were recruited.

However, last week's Public Service Pay Commission report noted that the cuts experienced by hospital consultants were "particularly severe" - with a greater differential in pay between the pre-2012 group of consultants and the new entrants than for other categories of public servants.

It confirmed that there were significant ongoing recruitment and retention difficulties among hospital consultants, with up to 500 unfilled vacancies, and some vacant posts failing to attract any applicants at all.

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The situation is further complicated by the fact that in 2009, the Government breached a pay contract with hospital consultants - a dispute which was only settled this year, with significant back money and higher pay rates due to pre-2012 consultants. 

That settlement will stretch the gap between pre- and post-2012 consultants to up to €50,000 a year. 

The PSPC recommends that parties to the Public Service Stability Agreement should jointly consider what further measures could be taken to address the problem.

IMO President Dr Peadar Gilligan called on the Government to immediately engage in talks to end the two-tier pay regime.

He said doctors had not traditionally tended to engage in industrial action to resolve matters - but that the frustration and anger over this long-running issue made that prospect all the more likely. 

He acknowledged that consultants are among the highest paid public servants - but said the issue was now impacting on patient care. 

He accused the Government of rejecting all recent efforts by the IMO to address the matter, warning they must face the consequences of the ongoing failure to right this wrong. 

The consultant dispute takes place against the backdrop of frustration across the public service about the two-tier pay system.

Talks are due to get under way between public service unions and the Government as to a pathway for restoration. 

At the moment, it is understood the focus is on mechanisms for allowing the so-called new entrants to "leapfrog" incremental points to progress faster to the top of the scale, to compensate for starting on lower points.

However, unions will also be seeking restoration of allowances which were abolished for new entrants.