An all-out junior doctor strike causing major hospital disruption could take place next following the completion of an IMO ballot in the coming days.

The IMO is balloting junior doctors on industrial action in protest at the HSE's failure to implement an EU legal requirement for a 48-hour maximum working week. Most juniors currently work on average more than 60 hours a week and some work over 100 hours, according to the IMO.

Full strike action, should it go ahead, could involve doctors withdrawing from all except emergency care in hospitals. The IMO wants a commitment from the HSE to end junior doctor shifts of more than 24 hours and to limit the working week to 48 hours by the end of 2014.

IMO junior doctor chairman Dr John Donnellan told irishhealth.com that it would go against the training and your mindset of doctors to go on all-out strike. But non-consultant hospital doctors (NCHDs) were 'fed up' with the HSE's failure over the past 10 years to implement maximum working hours and they wanted to 'get them (the HSE) to sit down and listen to us'.

With little progress made in recent talks on the issue, the IMO met with the HSE earlier today to discuss contingency plans for hospitals if, as is likely, junior doctors vote overwhelmingly for industrial action.

Following the meeting, however, the IMO said no agreement was reached on contingency plans  which means they will require further clarification when the nature of the proposed industrial action is decided by the IMO after the ballot was completed early next week. The two sides plan to meet again on Thursday.

Dr Donnellan said after the ballot result is known next Tuesday September 3, the IMO NCHD committee would decide what format the industrial action should take.

The IMO said it will cooperate fully with providing emergency cover during any industrial action and sufficient notice, within statutory limits, will be provided to the HSE to allow contingency arrangements to be put in place.

"We have to decide on what action we are prepared to take and what is going to be safest and fairest for patients," said Dr Donnellan.

"At the same time it has to be something that has to strike a meaningful, resonant note with HSE management. They have had 10 years to get the working hours issue sorted out. Whatever we do will have to impact management but at the same time we don't want to do anything that is going to affect patient care, and definitely not emergency services."

In previous strikes by nurses and doctors, all except emergency care has been curtailed in hospitals.

The HSE has said implementing the EU directive on maximum junior doctor working hours poses significant challenges. It previously said it planned to eliminate 24-hour plus continuous shifts by the end of the year.

Why are junior doctors threatening strike action?