Ireland's best doctors are being forced to seek work elsewhere because of deteriorating working conditions and severe budget cuts, a leading representative body has claimed.
The Irish Hospital Consultants Association (IHCA) also warned that the 28 emergency departments across the country can no longer be sustained due to a lack of resources.
Advocating a reduction in the number of hospitals providing round-the-clock emergency services, IHCA president Dr Denis Evoy said the development of new hospital network systems would be a "smarter way of ensuring the best patient care possible".
At the 25th IHCA annual conference in Maynooth, Co Kildare, Dr Evoy told delegates that around 20% of consultant posts in the public system are either vacant or filled only on a temporary basis.
"The continued degradation of consultants' working conditions and contracts is changing the medical landscape in Ireland and resulting in a system that cannot cater for its patients," he said.
"Ireland's health service is being run with a focus on the implementation of declining annual budgets rather than encouraging excellence across the system and making patients the priority.
"An extra 230,000 patients went through the doors of our hospitals last year compared with 2007, a period that has seen cuts of around a quarter in acute services budgets.
"The continued focus on absolute budget cuts rather than a targeted emphasis on strategic savings is destined for abject failure. Our health system and the frontline workers in this system cannot continue to deliver the services being expected from them while maintaining acceptable levels of patient care.
"Ireland competes on a global level and it can no longer recruit and retain the most talented doctors and consultants. The brightest and best graduates, having finished prestigious fellowships, are accepting well-resourced and well-remunerated posts in America and Australasia."
The reconfiguration of existing and new hospital networks could potentially have a positive impact for both patients and frontline staff, Mr Evoy said.
"Consultants can help bring about reform and aid in the reconfiguration of acute hospital services."