Talks have concluded between health service managers and hospital consultants on new working arrangements this morning, almost eight hours later than the deadline set by Minister for Health James Reilly.
They have failed to reach an agreement on the issue of pay for new consultants, as well as rest days.
The government will now proceed with a 30% pay cut for new consultants despite the fact that the Irish Hospital Consultants Association and the Irish Medical Organisation say they do not agree with the decision.
That means new consultants will earn €50,000 less than those currently working. The issue of rest days will be referred to the Labour Court.
Agreement was reached on a number of other issues including rosters and new working arrangements for clinical directors.
National Director for Human Resources at the HSE, Barry O'Brien, says the pay cut for new consultants is going ahead immediately - regardless of the failure to reach an agreement.
"The IMO and the IHCA have clearly stated they do not agree but they have accepted that it is the government's right to proceed and take that decision, having regard for the financial challenges facing the health service.
"While we're aware they don't agree, we have clearly advised them that we are proceeding immediately with that decision."
Consultants will now have to consider proposals on the issues that were agreed upon.
The Irish Hospital Consultants Association says this will take some time though.
Its secretary general Martin Varley says they could not agree to any deal which would see consultants work on-call for 26 days out of 28.
He accepts that the issue of pay for new consultants is not a matter for the Labour Court and it doesn't fall under the auspices of the Croke Park agreement but he says they can't support the proposal: "We have had no proper consultation on the new hospital consultant grade and that's basically the issue.
"It's not included in Croke Park as far as we can establish and therefore it hasn't been dealt with in that context."