Doctors’ hours - Welfare of patients is at stake

If Martians landed here and went to hospital for emergency treatment they would know they were on a different planet in more ways than one.

would be a very real prospect of being attended by a doctor who had been working for anything up to 36 hours. If they were smart, they would high-tail it to another galaxy.

Such long working hours are commonplace for non consultant hospital doctors in Ireland, even though the practice is repugnant to EU directives, Irish legislation and common sense. All other sectors of our society have to ensure that employees are given both a safe place and a safe system of work.

We would not tolerate bus drivers, train drivers or pilots working such dangerously long hours, so why do we accept that someone potentially making life or death decisions should be forced to work round the clock? Nurses wouldn’t put up with it and neither would consultants but what the HSE persists in calling “junior doctors” have to.

The term junior doctor is a handy one, being less cumbersome than non-consultant hospital doctor, but it could also be seen as mildly offensive, suggesting that they are somehow lesser creatures than the consultants they work with side by side on a daily basis.

They may be less experienced but they are, for the most part, highly skilled and highly motivated. Today’s strike will demonstrate just how essential they are to the nation’s creaking health service.

The Irish Medical Organisation (IMO), which represents the doctors affected, is demanding an end to shifts over 24 hours and claims that the HSE has not engaged in any meaningful way to address their concerns.

It is more than 21 years since the EU introduced legislation to limit working hours. This was incorporated into Irish law in 1997 but, incredibly, it was not until 2004 that it applied to junior doctors. Even more incredibly, it has never been fully implemented in our hospitals and current medical rosters are in clear violation of both the EU directive and Irish law.

The IMO wants an assurance that hospitals will take steps to ensure compliance with the European Working Time Directive and the introduction of a 48-hour week. That seems to be a very benign request.

However, the IMO has demonstrated an odd doublethink with its demand that hospitals that do not comply be subject to sanctions amounting to double pay for shifts of more than 24 hours. They say that this would act as a financial penalty on hospitals which breach the shift limits but it is contradictory to turn the argument against long hours into a money issue.

Nevertheless, the central complaint about long working hours has been going on for 10 years and the HSE continues to drag its heels. The suggestion by Health Minister James Reilly that the sanctions for breaches could involve switching authority to a different manager, or considering the extent to which an individual manager should be held accountable, lacks clarity. In any event, it is far too little, far too late. It is also extraordinary that the welfare of patients appears to be secondary to an issue that has dogged the health service for years.

It would be a tragedy if it was to take a fatal mistake by an overworked doctor to demonstrate just how unsafe the current practice is.