Consultants in public hospitals could be paid up to 250 thousand euro per year, under a proposed new contract.
Under plans approved by the government, consultants will be asked to work longer hours and can be rostered from Monday to Saturday.
The Health Minister expects the change to reduce waiting lists for consultants, which currently stand at 900 thousand people.
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Stephen McMahon from the Irish Patients Association supports the new agreement but says it could go further.