The Irish Medical Organisation has become the latest public service representative body to recommend its members reject the terms of Croke Park II.
Following a meeting of the executive council of the doctors’ union, it also said it backed the decision by its negotiators to withdraw early from talks between unions and management on a new deal.
The union confirmed it would ballot members but added: "The council agreed unanimously to recommend that members would vote against the proposals."
The IMO’s director of industrial relations, Steve Tweed, said it would now campaign strongly to try to secure a no vote.
"Our opposition to these proposals is based first and foremost on the risk we believe these proposals pose to patient safety and care. As far as our members are concerned, they are designed to force doctors in public hospitals to work longer hours for less pay and that poses a real danger to the lives of the patients those doctors have to treat and to the health and wellbeing of the doctors themselves."
Today, the IMO, Irish Nurses and Midwives Organisation, Unite and the Civil Public and Services Union will launch a joint national campaign for a "no" vote in Dublin.
Meanwhile, Alan Shatter, the justice minister, has ruled out re-opening talks on the extension of the Croke Park Agreement for gardaí and said members of the force were ill-served by trade unions who walked out of talks. However, Mr Shatter said he and the Garda Commissioner were still willing to have discussions with members of the force and that his door was open.
Speaking to the Dáil, he said the Garda Representative Association (GRA) and the Association of Garda Sergeants and Inspectors (AGSI) had made a mistake walking out of the recent talks. Those bodies, along with nursing unions, have spearheaded the opposition to cuts to premium payments which, they say, will unfairly cut the take-home pay of their members.
The minister signalled there was no scope to re-examine the extended agreement which was signed off on by the Labour Relations Commission last week with unions who remained in the talks.
"I have genuine concerns about the position in which members of the force now find themselves," said Mr Shatter. "I think that the force was very ill-served by the conduct of the GRA and the AGSI in stepping outside the talks."
The AGSI executive will today complete a two-day meeting during which it will decide whether to escalate its protest.