Hospital work hours - Justice at a price for new doctors

With the health, and possibly the lives, of patients at risk, the decision of the EU Commission to refer Ireland to the European Court of Justice over persistent breaching of work-time rules will be applauded loudly in every hospital in the country.

Not surprisingly, the move is focused primarily on the unacceptable hours junior doctors have worked for years, a controversy that came to a head two months ago when 3,000 non-consultant hospital doctors went on strike. Seemingly, they were more aware than their bosses of the dangers of working around the clock work in such a sensitive area as the public health service.

Their frustration with a system designed to squeeze the maximum from a diminishing workforce was tragically illustrated at an inquest earlier this week, when the mother of a junior doctor who took her life blamed the suicide on excessive working hours [url=http://www.irishexaminer.com/archives/2013/1119/ireland/jessicaaposs-95-hour-weeks-were-immoral-says-mum-of-junior-doctor-who-took-own-life-250020.html]and described her daughter’s 95-hour weeks as “immoral”.

If the HSE believed it had resolved the long-running dispute with doctors by clinching a deal where 76% of them voted to accept proposals that all doctors would work no more than an average of 48 hours a week by Dec 2014, yesterday’s referral to Europe’s highest court reflects dissatisfaction that they will still end up working 36-hour shifts and more than 100 hours a week over the next year.

Basically, the function of the European Court of Justice in Luxembourg is to ensure every EU state interprets and applies European law in the same way. Effectively, the commission has decided to put Ireland in the dock because of its long-running failure to ensure that young doctors are not forced to work more than 48 hours a week on average, including overtime.

Much to the HSE’s discredit, some doctors were virtually asleep on their feet when they should have been alert and looking after sick patients. In comparison with the hazardous hours hospital doctors work, averaging up to 75 hours a week, the standard duration demanded by the EU could nearly be described as a holiday.

This deplorable regime speaks volumes about the dysfunctional nature of a health service where, for example, hardworking nurses on the front line were subject to cuts while parking charges and shop revenues were outrageously being used to top up the salaries of highly paid hospital bosses.

Moreover, it illustrates the failure of successive governments to take more timely action in other areas where the State has also breached EU rules. Inaction on such issues as human rights, the environment, and the plight of asylum seekers, has earned Ireland a bad reputation for foot-dragging.

Besides attracting the suspicions of other EU citizens, the cost to the taxpayer has been significant. The regrettable national tendency to fall out of step with the rest of Europe on a variety of important issues has cost the State €3.5m, including €2m for delaying to sort out the septic tank problem.

Thanks to our stubborn refusal to comply with rules on working time limits, young doctors are leaving the country in droves. At the end of the day, the tragedy is that, having come through a costly 7-year educational regime, many will be lost to this country for ever. That’s a high price to pay for a disorganised HSE.


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