IMO: Three-in-four trainee hospital doctors exceed 48-hour week

A new survey by the IMO finds that trainee doctors are working more than a 48-hour week.

Almost three-in-four trainee hospital doctors say they are working more than a 48-hour week in breach of current EU guidelines, a survey carried out by the Irish Medical Organisation (IMO) has found.

The survey of 600 non-consultant hospital doctors (NCHDs) – around 10% of more than 6,000 employed across the health service - has also raised concern over the accuracy of official records that suggest far higher compliance levels.

Strike action by NCHDs in 2013 led to a new EU Working Time Directive (EWTD) agreement that no trainee hospital doctor should work more than 48 hours per week or more than 24 hours straight. Monitoring arrangements were also put in place to track compliance, which should be 100%.

There are now questions over compliance with the EWTD agreement for trainee doctors, who dispute HSE reports that most hospitals are compliant.

The latest HSE figures show that in August training hospitals were 85% compliant with the 48-hour week threshold and that 98% were compliant with the maximum 24-hour shift, although there is variation between individual hospitals. Almost 1,000 doctor’s hours were not compliant with the EWTD, the figures show.

Monthly HSE figures also suggest that EWTD compliance levels on a 48-hour working week ranged from 86% - 89% in the first eight months of the year.

The IMO NCHD committee, however, disputes official compliance rates.

“Hospitals are still failing to meet that standard,” Gabriel Beecham, a trainee doctor and member of the committee said.

“Out of the 600 NCHDs surveyed to date, 74% reported working more than 48 hours per week on average,” he said, adding that 34% said their working hours did not accurately reflect actual hours worked and 24% said they had been asked to modify their hours for EWTD reporting purposes.

While more doctors were recruited in recent years working 24-hour shifts was still considered the norm, he said.

As an “extreme example”, he recalled working three 24-hour shifts in a week on one occasion.

Trainee doctors, he said, are looking for the 2014 agreement to be honoured and for a “reasonable work-life balance”.

“No expert in the world will tell you that working for 24 hours straight is safe. We’re looking to move beyond that to a maximum 12 to 13-hour shift,” Mr Beecham said, adding that fatigue poses a “real risk” to the safety of patients and doctors.

The HSE was previously taken to the European Court of Justice for EWTD breaches but not fined.

IMO industrial relations officer, Paul Maier, said continued breaches of EWTD thresholds are against the law and that the survey would continue to determine the scale of the problem and inform future actions.

“Any and all options are being considered right now,” Mr Maier said, adding that the survey was canvassing trainee doctors on the “best way forward”.

The HSE did not comment specifically on claims made about the accuracy of reported working hours but said adherence to the 2014 guidance was expected.

“Any indicators that suggest a potential concern in relation to compliance is managed through the Performance & Accountability Framework, supplemented by site visits under the EWTD Verification Group, if/and where considered appropriate to the circumstances at hand,” a spokesperson for the HSE said.