Excessive working hours for Non Consultant Hospital Doctors may have serious or even fatal consequences – Irish Medical Organisation tells Oireachtas Joint Committee on Health and Children

• Excessive working hours for Non Consultant Hospital Doctors
• NCHDs working an average of 60-65 hours a week, not the 54 hours claimed by the HSE

Tuesday March 5th 2013: The current system where Non-Consultant Hospital Doctors (NCHDs) are routinely working more than 60 hours a week – well in excess of the requirements of the European Working Time Directive (EWTD) – is jeopardising patient care and will result in accident with serious or even fatal consequences according to Shirley Coulter. Ms Coulter is Assistant Director for Industrial Relations with the Irish Medical Organisation.

In a presentation to the Oireachtas Joint Committee on Health and Children, Ms Coulter strongly rejected a claim by the Health Services Executive that NCHDs are working an average of 54 hours a week. “From our own data it is clear that the average is between 60 to 65 hours a week.

“The HSE use of averages serves only to mask the true extent of the dangerous working hours required of NCHDs including many working in excess of 100 hours a week and continuous shifts of up to 72 hours on site often without appropriate rest or sustenance. The HSE must accept its responsibility to doctors and patients alike to ensure that safe working practices are implemented in all hospitals without delay,” Ms Coulter said,

She added that the focus now must not be on the problems but the solutions and that the key objective of the current NCHD campaign are to limit the maximum shift length to 24 hours, limit the weekly average to the EWTD compliant of 48 hours, protecting training time and the removal of NCHD-inappropriate tasks.

Ms Coulter said that over 30% of an NCHD’s working time is spent on tasks such as intravenous medication, phlebotomy and ECG’s, all of which do not require a doctor. “At weekends, NCHDs can spend in excess of 4 hours undertaking routine phlebotomy – the equivalent of five working weeks a year - which could be undertaken by other non-medical grades of staff,” she said, adding that delegating non-medical duties to grades would facilitate a reduction in NCHD hours and would allow them focus on other aspects of patient care and improve the efficiency of servicer delivery.

Ms Coulter warned that there was a lack of accountability in the HSE which meant nobody was ever sanctioned for the organisation’s failures towards NCHDs. She said that this was exacerbating the problems of recruitment and retention of NCHDs. “Doctors may choose not to complete lengthy training in a health service that disregards their contract, requires onerous illegal working hours under difficult working conditions and has limited career planning, without the prospect of a Consultant post remunerated at a level equivalent to the Consultant they work alongside,” she stated. Ms Coulter added that the impact is already being felt with the HSE having to readvertise almost 20 per cent of Consultant positions last year.