Doctors’ hours cut ‘will hurt patients’

PATIENTS will suffer and waiting lists will increase once junior doctors’ working hours are reduced, a leading surgeon has warned.

Professor Frank Keane, chair of the college committee of the Royal College of Surgeons (RCSI), said unless consultant numbers were substantially increased to tie in with the introduction of the European Working Time Directive (EWTD) in August, patients would suffer.

This, he said, was because a shorter working week would place consultants under pressure to train surgical interns in a shorter timeframe.

Educating non-consultant hospital doctors (NCHDs) in parallel with full employment will be much more difficult when NCHDs hours are cut. Most NCHDs currently work a 75-hour week. The EWTD will see that cut to 58 hours from August 1.

“I will have to use all my clinical time teaching and will see less patients. In the operating theatre, I will also have to assist and teach and will get less work done, creating longer waiting lists. Patients will suffer,” Prof Keane said.

More consultants were needed if the EWTD was to be implemented, as recognised in Hanly, one of three major reports on reform of the health services. However, Prof Keane said there was “no clear indication of how we will get them”.

Hanly envisages a much larger number of consultants, working in teams, with revised working patterns, and a significantly reduced number of NCHDs. Acute hospital medical services would be consultant-provided, rather than consultant-led.

The Irish College of General Practitioners expresses major reservations about crucial aspects of the health reform process in a discussion document to be published shortly.

The draft document stresses that the individual doctor-patient relationship has always been an integral part of general practice and hospital care. There are concerns about the future of this in a hospital system with a greater emphasis on working in teams.

ICGP chairman Dr Richard Brennan told Irish Medical News there were fears that under the new system, patients could find themselves being admitted by one doctor, operated on by another and discharged by yet another, and it was possible a single patient could be seen by up to seven separate specialists in the course of their stay.

“There could be issues around the quality of service because there is a danger that no individual might be given the ultimate responsibility of care,” Dr Brennan said.