Spectator Health

Jeremy Hunt opens the attack on the Working Time Directive

23 July 2014

11:10 AM

23 July 2014

11:10 AM

For years, Secretaries of State for Health have studiously ignored one of the most corrosive regulations to the NHS: the European Working Time Directive. Although the EU is not supposed to have any remit over health, this ‘health and safety’ directive limits junior doctors’ hours to an average of 48 hours per week, with added ECJ judgements imposing compulsory immediate compensatory rest time should hours be breached – and ‘on-call’ time classed as work, even if the doctor is fast asleep. This rigid imposition is neither healthy, nor safe; with junior doctors complaining that it has led them to do illicit work to get sufficient hours of training in, unpaid, less supervised, resulting in them being more tired and less trained.

It has resulted in more hand-overs (when vital patient information can get misinterpreted or misplaced), and lost the NHS approximately 400,000 hours of surgical time a month. The ECJ rulings on doctors having to take immediate compensatory rest if they go over their allotted hours has cancelled countless clinics as doctors have been ordered to rest instead of operating on patients ready and prepared for their surgery. For patients, it has resulted in hardly ever seeing the same doctor twice, and overall many senior doctors say it is eroding the concept of professionalism in the NHS, pushing a ‘clock on, clock off’ mentality on trainees.

Doctors, trainees, MPs like myself, Andrea Leadsom and organisations like Open Europe have been vocal on what can literally be a fatal directive – it has already been listed as a contributory cause of death on at least one coroner’s report.

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And Britain is not alone; across Europe, countries with less compunction about breaking the Euro-rules have been trying to by-pass this destructive regulation.

But, thankfully, one secretary of state has at last grasped this toxic nettle. Jeremy Hunt bravely commissioned the Royal College of Surgeons to look at the impact of the directive, which was negotiated and introduced by Labour, and which has only recently taken full effect. The College came up with a number of recommendations. One of which, the Government has just embraced – encouraging junior doctors to exercise their opt-out from the directive.

The Royal College of Surgeons recommends an optimum of a 65 hour working week. No one wants a return to the 100 hour weeks of exhausted trainees; but that flexibility is vital.

The opt-out will help, but it is testament to the lunacy of the EU as currently articulated that a directive unpopular across Europe, which is costing lives, in an area over which the EU is not supposed to have a competency, can only be circumvented by encouraging junior doctors to opt out on an individual basis, and by trying to redefine working time and training time, as other countries have done.

Jeremy Hunt deserves full credit for listening to front-line staff and tackling this unsexy, but disastrous directive. When pen-pushing bureaucracy is literally fatal and a common-sense solution is almost impossible, you know that an organisation needs change. But how many coroners’ reports will it take for the EU to wake up to this reality?

Charlotte Leslie is Conservative MP for Bristol North West

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  • Mynydd

    Mr Hunt is responsible for the NHS in England, therefore responsible for hospital management, including the working times, rest times, on-call times, and training

  • Marmalade Sandwich

    According to the GMC, 37 percent of doctors in the UK were trained overseas. What a disgraceful figure. Think how some of the poor countries these doctors are from suffer when they flee abroad for more money. Do they care for the health of their country folk? This should not be allowed. Sure, organise exchanges, but we should be training our own doctors. After all, medicine is a rewarding career.

  • fundamentallyflawed

    In what mad world is a 48 hour working week not enough especially in an inexperienced Doctor who is making decisions that might effect the rest of a patients life

  • Colonel Mustard

    Unfortunately this will just be re-played by Labour as tired doctors being forced to work longer hours by evil Tories and that, as always, will be the narrative that takes root.

  • goatmince

    It is frankly curious that we no longer care to train our own – is there a single medical school in Britain? (Don’t answer that) Well, where are all the British surgeons then? (Answer that one instead)

    I know what: just fill the ranks with foreign trainees and blame them when stuff goes wrong. Vote UKIP!

    • Jack

      I’ve had four surgeries in the last ten years and all were performed by English people. A friend of mine went to medical school in Birmingham so there are medical schools. The problem isn’t the fact that we’re not training them, it’s that enough youngsters aren’t choosing medicine as their field of study/work. When there’s so much more money in other fields it’s not that surprising, though. Why go into surgery when you can be a banker with a Ferrari collection by the time you’re 35.

    • Jack

      In fact, here’s a list of medical schools you or your children (depending on your age) can go. All you need is very good grades, academic references and a penchant for exams. Good luck.

      Aberdeen (University of), School of Medicine

      Barts and The London School of Medicine and Dentistry, Queen Mary, University of London

      Birmingham (University of), School of Medicine

      Brighton and Sussex Medical School

      Bristol (University of), Faculty of Medicine

      Cambridge (University of), School of Clinical Medicine

      Cardiff University, School of Medicine

      Dundee (University of), Faculty of Medicine, Dentistry and Nursing

      Edinburgh (The University of), College of Medicine and Veterinary Medicine

      Exeter (University of), Medical School

      Glasgow (University of), College of Medical, Veterinary and Life Sciences

      Hull York Medical School

      Imperial College School of Medicine, London

      Keele University, School of Medicine

      King’s College London School of Medicine (at Guy’s, King’s College and St Thomas’ Hospital)

      Lancaster University, Faculty of Health & Medicine

      Leeds (University of), School of Medicine

      Leicester (University of), Leicester Medical School

      Liverpool (University of), Faculty of Health and Life Sciences

      London School of Hygiene and Tropical Medicine (Postgraduate Medical School)

      Manchester (University of), Faculty of Medical and Human Sciences

      Newcastle University Medical School

      Norwich Medical School, University of East Anglia

      Nottingham (The University of), Faculty of Medicine and Health Sciences

      Oxford (University of), Medical Sciences Division

      Plymouth University Peninsula Schools of Medicine and Dentistry

      Queen’s University Belfast, Faculty of Medicine and Health Sciences

      Sheffield (The University of), School of Medicine

      Southampton (University of), School of Medicine

      St Andrews (University of), Faculty of Medical Sciences

      St George’s, University of London

      Swansea University, School of Medicine

      University College London, University College Medical School

      Warwick (The University of), Warwick Medical School

  • anyfool

    Is this not an indication of how we as a country have elected a bunch of weak minded morons over the last few decades.
    None have ever had the nerve to say stop this madness, it is not just health it is almost all sectors of life where we, as well as the political classes have abrogated responsibility.
    We are not a nation anymore, we are just a group of cyphers on course to become unthinking units run by a committee.

    • http://google.co.eu Sentinel

      Junior doctors can choose to work more than 48 hours per week, as the author admits (fifth para). But I wonder how many read past her claim of it being a “rigid imposition” (first para)?

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