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Are patients put in danger by doctors' working hours?

31st July 2009

The European working time directive aims to restrict doctors’ hours. Mr John Black, president of the Royal College of Surgeons and Dr John Coakley, medical director at the Homerton Hospital offer their views.

docstalkingpatientsQ

John Black:

The European Working Time Directive was designed for the wellbeing of manual industrial workers, yet doctors are bound by it. For some medical groups this is not an issue but surgeons have to do both elective surgery and have an out-of-hours responsibility for emergency surgery.

There are not enough doctors to work a 48-hour week.

Out-of-hours operations are urgent cases but instead of three people in the past, there may just now be one doctor having to work frantically. The patient sees thin layers of cover and frequent handovers between doctors meaning patients often have to repeat their stories.

High frequency handovers and rushed doctors on exhausting shift systems are real risks to patient safety.

The EU directive will also be a disaster for training and if there is a swine flu epidemic the directive will cause mayhem. Beds will be needed, operations will be delayed and the extra hours that doctors need to work will have to be paid back later, closing down large areas of the NHS.

John Coakley:

When my father trained as a doctor he worked 120 hours a week. He thought I had an easy life when my training was 72-84 hours a week.

Hours are being whittled down as expectations change, which is good for work-life balance.

For a junior doctor at the start of their career, the new directive is good, but senior doctors fear young doctors are not getting enough training.

Working too much is bad for anyone. If a surgeon has worked for more than 12 hours I do not want him operating on me.

Working a 48-hour week with limited shift lengths is safer for the doctor, which means less harm to patients and long hours do not deliver better training or experience.

Most of Europe works less than a 48-hour week, for health and safety reason. Doctors should be subject to the same rules as everyone else.

 

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