Dr Colin Doherty, consultant neurologist at St James's Hospital, Dublin, said that 23 trials carried out had proven that when patients were dealt with immediately by consultants in the field of their complaint, and were given specialised care, it decreased their length of hospital stay considerably.

"For instance, if a patient suffering from a stroke was admitted to an acute stroke unit and given expert care, the incidence of mortality was reduced, longterm disability was decreased and, most significantly, it reduced the average length of stay in hospital by six days per patients, " said Doherty. Overall, this saved 100,000 bed days in the area of neurology.

"That's just one area of speciality, " said Doherty. "If this was extended to all areas, bed days would be reduced substantially.

We have clear evidence of this. It's a question of how the patient is dealt with to increase efficiency."

Specific clause While the proposed consultants' contracts could theoretically go some way towards addressing this problem, a specific clause in the contract prevents consultants from being given development costs with their jobs and they will therefore have no resources to employ the necessary back-up staff, Doherty said.

"It doesn't make any sense, " he said. "I have no problem with the idea of the contracts but it does basically mean that the government is paying me more to do less.

My hospital has been incredibly supportive of me but the resources are already not there from the HSE and I have to spend a huge amount of my time on administration that could otherwise be spent on treating patientsf With the new contracts, we will simply have more consultants looking to share the part-time secretary available to us and the entire system becomes more inefficient."

The HSE has advertised 68 new consultant posts on revised terms and conditions, with salaries of up to 205,000 plus potential performance bonuses in many cases. Consultants have rejected the contracts, saying they will only consent to contracts that have been agreed and not imposed on them.

What consultants needed was not necessarily more money, said Doherty, but more resources and more trained people to back them up. "If I keep people out of hospital, if I keep them well and if I can decrease their disability, then I am being efficient. Right now, I am totally inefficient because the HSE will not consider providing the proper resources, " he said.