Irish-trained doctors are queuing up to leave our health service, the Irish Medical Organisation (IMO) has warned.
It said that the HSE is "not serious" about tackling the recruitment crisis for consultants in the Irish health service.
It follows the collapse of talks at the Labour Relations Commission (LRC) on a new deal on pay and career structures.
The HSE will begin advertising for hospital consultants on new higher pay scales, which have been proposed by the LRC. However, the new rates have not been agreed by the IMO.
Health Minister Leo Varadkar waded into the row saying that the new consultant pay proposals are "very good by anyone's reckoning."
He said the proposals had been accepted by the HSE and would allow consultants to earn €175,000 at the top of their salary scale, which was comparable to salaries in other English-speaking countries.
He added that there were a large number of vacant consultant posts across the health service and this is impacting on waiting times and patient care.
Under the new plans, pay for newly appointed consultants working exclusively in the public hospital system, will increase from an existing scale of €116,000 to €121,000 to between €127,000 and €175,000 over time.
New consultants with experience would be appointed at an entry level of up to €155,000, and there would be scope for receiving higher salaries for taking on more senior posts as heads of departments or clinical directors.
Steve Tweed, director of industrial relations at the IMO, said that Irish-trained doctors were queuing up to leave the Irish health services but the HSE was acting as if the queues were coming the other way.
"There's a complete contradiction between the HSE approach and the facts on the ground where we have a health service that is dangerously understaffed at specialist level.
"This is a crisis and the HSE seem to think that they can ignore the extraordinary demand that exists internationally for Irish-trained doctors and simply carry on putting forward proposals that will not solve the problem.
"The reality is that our doctors see better jobs with better pay and better conditions in various markets across the world and they are voting with their feet."
Mr Tweed said the IMO would be prepared to re-engage in talks with the HSE if they could demonstrate that they were prepared to work with the IMO to tackle the problem.
"We want to create a health service which serves the needs of patients and the widercommunity.
"We believe we can help the HSE tackle this recruitment crisis but we need them to engage seriously and constructively with us on this critical agenda. They are not doing that now," Mr Tweed said.
The HSE said that consultant posts based on the new pay scale proposed by the LRC, which comes into effect from September 1, will now be recruited.
"The LRC proposals give full regard to the relevant experience of doctors returning from abroad or currently in the Irish health system, and ensure that such experience influences where doctors are placed on the new pay scale." the HSE said in a statement.
"Health Service Management will be engaging further with the IMO and other relevant parties on the implementation of these arrangements," it said.