HEALTH Minister Dr James Reilly has promised that the Government is committed to driving down junior doctors' long working hours.
As non-consultant hospital doctors (NCHDs) consider proposals to prevent a re-run of a day strike over 24 hour shifts, the minister insisted all hospitals will be forced to comply with European laws on working hours by the end of next year.
"I want to create a health system that protects, nurtures and develops the people who work within it," Dr Reilly said.
"That is why I am determined to change the role of NCHDs within our health system.
"It is essential that doctors enjoy reasonable working conditions. I want to reassure hospital doctors that the Government is committed to achieving compliance with the European working time directive in respect of NCHDs by the end of 2014."
Dr Reilly, who appeared before the Oireachtas Health Committee to give an update on his department, said the Government would look at NCHD working patterns, attendance systems and the reorganisation of services.
The Irish Medical Organisation (IMO) is to recommend that NCHDs accept new proposals drawn up by the Labour Relations Commission.
Under the new plans, which are to be balloted on, hospitals could face financial sanctions if they breach rules and force junior medics to work more 24-hour shifts.
The agreement was reached between the IMO and Health Service Executive during intensive talks, which followed appeals by Taoiseach Enda Kenny and Dr James Reilly for both sides to attempt to resolve the long-running dispute.
Doctors had warned that a second strike could last two days.
Fifty-one hospitals were hit by a walkout by 3,000 non-consultant hospital doctors (NCHDs) with pickets outside at least eight hospitals for most of the day on October 8.
About 12,000 outpatient appointments were cancelled and about 3,000 operations postponed as a result of the strike.
HSE director general Tony O'Brien said he was hopeful junior doctors would vote to accept the deal.
He said, as of September, 76% of NCHDs were compliant with a 24-hour shift and a further 6% worked no more than 26 hours continuously.
He said these figures underline continuing progress - when compared to the first half of the year.
"One issue remaining between the sides is the matter of sanctions and the HSE has put proposals to the IMO to resolve this issue," Mr O'Brien added.
"The HSE and IMO have now concluded negotiations facilitated by the LRC and yesterday the IMO NCHD Committee agreed to put resolution proposals to a ballot of members.
"It is hoped that this will lead to a final resolution of the dispute."
Elsewhere, Dr Reilly was forced to defend his controversial decision in the budget to review the provision of medical cards.
The minister has been unable to explain how many people stand to lose their card as the Government ramps up its scrutiny of eligibility in a bid to save 113 million euro.
"People who are entitled to their medical card have nothing to fear," he insisted.
Dr Reilly said official research had shown there was currently no equity in the criteria applied to people across the country - saying someone in one area could get a medical card while a person with the same criteria in another could not.
He said there would be no change in policy, people would simply have to reply to a letter sent by the HSE outlining their eligibility.
He said eligibility for a medical card is based on a person's finances.
"The medical card scheme never operated on the basis of a medical condition or an illness. It operates on the basis of undue financial hardship," he said.
Dr Reilly said the aim of saving 113 million euro from so-called medical card probity was based on research given to his department.
The HSE says almost two million people are covered either by a medical card or a GP visit card - 43% of the population.
It says that at October 1, 52,733 medical cards and 22,115 GP visit cards were issued where a patient was above the income threshold.
"The assessment guidelines used in respect of cards issued in the case of an assessment of undue hardship for otherwise ineligible recipients have not been altered by the HSE since 2009," Mr O'Brien said.
He added: "I and my colleagues are as committed to ensuring that all those legally entitled to medical or GP visit cards are able to avail of them as we are to fulfilling our absolute obligations to ensure that those who are not entitled neither receive or retain them."
Dr Reilly admitted he is worried about achieving the savings outlined in the health budget, which total 666 million euros.
"I am, frankly speaking, concerned around what can be achieved here and I'm concerned about what can be achieved around Haddington Road," he said.
"And that's why I asked for the Taoiseach's department and the Department of Public Expenditure and Reform to be involved in assessing and validating these figures, and also the impact they will have on the service."
Dr Reilly insisted all the figures outlined by his department in the Budget on Tuesday were "real".
"I can tell you there is no black hole now," he said.
"We know where all the money is, where it is spent, and where it is going and how much we need."