Wednesday, 4 February 2009

On the European Working Time Directive, piss-ups and breweries.

So, in the most unsurprising news affecting junior doctors so far this year, I hear that plans to fully implement the European Working Time Directive (EWTD) for junior doctors have been put on ice for a while. For those who don’t know, doctors in training like me have been exempt from the full effects of the EWTD since it became law for junior doctors in 2004.

The plan was for the directive to be phased in over five years eventually establishing a 48-hour working week for junior doctors by August of this year. I know that the EWTD already applies to hospital consultants but I’m not sure about GPs (maybe someone can fill me in).

I love it that this is being spun as us “getting a choice” if we want to work more than 48hrs. The crucial line in this piece is.

The opt-out means that junior doctors will be able to work four extra hours if
their employer chooses.

Excuse me? I'll "choose" to work more hours if my employer chooses? Trust me, the junior doctors working at the front line will have no choice at all. The “choice” will not be ours, but that of the managers and consultants whose interest is the running of the department, i.e. the service, and absolutely nothing to do with our training.

Reducing the number of hours that each doctor works obviously necessitates changing the rotas that we are on and the numbers of junior doctors employed, but basically, hospital trusts up and down the land have had at least FIVE YEARS to sort it out.

Have they sorted it out? Have they bollocks. Some trusts put together a plan of action regarding steps they would take to achieve compliance, on the other hand, other trusts sat around and did fuck all about it. As August 2009 started to loom trusts “suddenly” realised that they needed to get their arses in gear and do something about the number of junior doctors that were still working 50, 60+ hours every week. They realised that they would face significant fines (£5000 per junior doctor per day, apparently) if they didn’t organise EWTD compliance and panic started to set in. Trusts employed managers to try and sort out the rotas and, to be fair; in some areas they were very successful.

Unfortunately, many trusts now realise that they haven’t planned well enough. They haven’t employed enough doctors or organised changes to how we juniors work. So now we have this fudge situation whereby full EWTD compliance has been put off for maybe two, maybe three years because some trusts couldn’t organise changes to the rotas of their juniors over a five year time span.

The words "piss-up" and "brewery" spring to mind.

Regarding the very separate issue of the impact of the EWTD on the training of doctors in the UK: I’ve already made my opinion known and my views haven’t changed. I do concede that I’m looking at it from the point of view of a trainee in a specialty (anaesthetics) where the training is fantastic and well organised. But, as I wrote before, if other specialties are worried about the training of their juniors, they should really take a good look at what their juniors are actually doing and providing more training time rather than having the attitude that “if the juniors are there all the time, then they’re more likely to see interesting stuff when it happens.”


Anonymous said...

Dude, I just posted about this on our blog. I was rageing when I heard about it, although unsurprised. Same thing is happening in Ireland.
Though we all knew the 56 hour limit was a joke anyway, when I was working in the UK, so I guess the 48 hours would have been similarly laughable too :(

Dr. Thunder

Dr Michael Anderson said...

It's a joke. It sounds like it's only going to be delayed in a few areas of the country, but still... How many years does it take to sort this out?

I'm not laughing

Anonymous said...

In my Trust we have a number of SpR vacancies which we can't recruit to. We can't get locums either. EWTD will require two more doctors to allow for compliant rotas with no impact on service. Even if we can fund them there is no indication we will be able to recruit to them.

Dr Michael Anderson said...

Anonymous. That has little to do with the EWTD and everything to do with MMC.

MMC basically told (and is still telling) bright, hard-working young people that they can't have a career in the NHS. Does it really surprise you that they didn't stick around?

The doctors have left.

Recruitment will be less of a problem in the next couple of years as those who did the foundation programme start to get to SpR level, but I think that this was the plan all along wasn't it? Despite the lies that the MMC architects told us

Anonymous said...

I don't disagree, and you're right it won't be an issue in 2 years time when there will probably be more doctors than we have jobs for. It doesn't help with EWTD though, given the timescales for that are this August.