‘Doctors’ training must count as work’
The Irish Medical Organisation (IMO) took the Government to the court to force it to bring junior doctors’ working hours within legal limits. Junior doctors can face 32-hour shifts and up to 100 hours a week.
However, the court’s advocate general focused on another issue — the fact that the 20 to 27 hours a month training time for the 4,500 trainee doctors is not counted as work.
Currently, patients have a one in three chance of being treated by a doctor who has worked for longer than the legal length of time when they go to hospital.
As well as working their shifts, intern doctors spend 20 hours a month training, while those studying to become surgeons spend 27 hours a month training.
At the moment, this is not counted as working time, but the advocate general said that, after studying how Ireland applies the Working Time Directive to hospital doctors, he felt a new point of law had been raised.
He rejected the Government’s case that there was “a fundamental distinction between protected training time which involves physical presence in the workplace and, on the other hand, time spent on-call, requiring physical presence in the workplace”.
The Department of Health and the HSE argued that since doctors in protected training time were not available for work, this could not be considered to be working time.
However, the court’s legal counsel — whose opinion is accepted by the judges in 80% of cases — disagreed and backed the European Commission’s opinion that it is all working time.
The HSE, the Department of Health, and the IMO signed an agreement on the standard contract of employment in January 2012 that says: “Interns, senior house officers, registrars, senior registrars, specialist registrars or otherwise for the purpose of providing medical or dental services and/or the pursuance of medical or dental training who for the purposes of such employment are not employed as consultants.”
In addition, it says that time spent training, as scheduled in the duty roster and at a time when the doctor is not on call, is not to be counted as working time.
Health Minister Leo Varadkar acknowledged current Irish practice was at odds with the court’s position.
“Agreement was reached with the IMO in the High Court settlement of 2010 that protected training time did not count as working time,” said Mr Varadkar. “However, that position is now in question pending the final judgment by the European Court of Justice.”
IMO assistant director of industrial relations Eric Young said this interpretation of the legislation could result in junior doctors and trainee surgeons not getting the kind of protected training time they needed. “Forty-eight hours’ working and training would not be enough to gain the skill sets they want — it is quite a big issue and could present quite a big problem”, he said.
He added that the legal opinion should serve as a wake-up-call to the HSE and the Department of Health to ensure all hospitals fully complied with the maximum working time with sufficient rest periods and time off.
The Department of Health said it was close to eliminating shifts of longer than 24 hours but cutting the average working week to 48 hours remained a challenge.
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