HOPES of a breakthrough in the junior doctors' dispute emerged after the Health Service Executive (HSE) said it would consider financial sanctions for hospitals which force medics to work shifts of more than 24 hours.
The offer comes after about 6,000-7,000 patients had their operations and outpatient appointments cancelled across the country's hospitals as junior doctors took to the picket line.
Although the scale of cancellations was lower than the original estimate of nearly 15,000, it has created a huge backlog of delayed appointments for patients.
The exhausted doctors walked off wards and pounded the pavements outside hospitals all day, warning that they may escalate their action further if the HSE continues to force them to work shifts of more than 24 hours and fails to introduce a 48-hour week by the end of next year.
However, late yesterday the HSE wrote to the IMO saying for the first time that it would consider imposing the financial sanctions on hospitals, which was a key demand of the junior doctors.
The junior doctor committee of the IMO will meet early this morning and there are strong signs they will return to the Labour Relations Commission for more talks.
It is understood the financial sanction could see the hospital docked for the equivalent of the rate of pay due to a doctor for every extra hour he or she works beyond 24 hours. The doctors were demanding that, along with the time and a quarter they get paid for each extra hour, they should get time off in lieu. If that is not possible, they should be paid the normal hourly rate.
The HSE said this was not possible because it would breach public pay rules. However, it would be possible to take the equivalent of the doctor's pay from the hospital. That would be coupled with other sanctions including removing responsibility from a manager who fails to regulate doctors' hours, and depriving the hospital of entering new trusts.
A spokesman for the IMO said it received the invitation for talks at the Labour Relations Commission but will wait until the junior doctors' committee meets today to decide on the response. He warned that the committee would also discuss the next stage of industrial action to be planned for next week should the HSE fail to agree meaningful sanctions.
The doctors are warning of an escalation, which could see a two-day national strike next week, or rolling strikes across the regions, said IMO industrial relations officer Eric Young.
This will see a growing backlog of patient cancellations, which will be difficult for hospitals to reschedule at an early date, putting patients in need of treatment and diagnosis at risk. The doctors would again reduce their level of cover to weekend levels.
Hospitals were helped yesterday by the decision of many patients not to attend emergency departments and to go to their GP instead.
A spokesman for St James's Hospital in Dublin, the largest in the country, said it had to defer 450 outpatient and 34 day-care appointments.
More than 90pc of the appointments have been rescheduled. There was no significant difference in attendances and waiting times at the emergency department.
About 450 outpatient and 34 day-care appointments had to be deferred at St Vincent's Hospital. There were 325 patient appointments and procedures cancelled across hospitals in Limerick and other areas of the mid-west.
By Eilish O'Regan