The level of juniors’ rota compliance with the Working Time Directive only looks good on paper, a survey of hospital doctors reveals.
The survey, by pressure group Remedy, shows that 47% of junior doctors believe their rotas fail to comply with the 48-hour week regulations, which were introduced on 1 August.
The government, however, claims that all but 200 derogated rotas are compliant. This discrepancy is because 36% of juniors say that while their rotas meet the target on paper, they fail to do so in practice. A further 11% say their rotas are not even compliant on paper.
Orthopaedics and general surgery had the greatest levels of non-compliance. The reasons given include shortages of doctors, the demands of clinical care and the requirements of training.
One respondent said: “We’ve agreed off-the-record to provide more weekend cover than is on paper in order to preserve a rota that will keep us on duty during weekday ‘office hours’ which is when the majority of our training occurs.”
Many juniors commented that their salaries had been reduced but they were working longer hours than this justified.
Another said: “On paper the rota is compliant. In reality, in order to make the rotas compliant, cover has been reduced to unsafe levels. I’m routinely working 2-3 hrs past my shift finish time and I’ve been told by personnel that my consultant will have to sign to say that I had to be there due to an emergency.
“The consultant has made it clear he will do no such thing as he is under pressure from management. This essentially goes for all juniors in this trust.”
Two thirds of the 309 respondents said they would take a voluntary opt out if they could. However, only 18% had been offered this by their trusts.
Remedy branded implementation of the WTD “a sham” and urged individual doctors to exercise their right to opt out.
Lindsay Cooke, co-chair of Remedy, said: “Trusts should have the courage to be honest. They should take a more realistic view over derogation, rather than participating in government-sponsored abuse of doctors’ work ethic. Tell the truth, someone.”
The reduction in doctors’ hours is making it difficult for hospitals to provide cover with middle grade doctors. Two weeks ago the European Commission threatened to investigate allegations that junior doctors in Scotland were still working excessive hours.
Problems have also been reported in Wales, where there is a vacancy rate of up to 25% in some key specialties and nearly 200 doctor vacancies in four Welsh NHS trusts alone.
Read the full results of the Remedy research.
“There are none as deaf as those who do not wish to hear”! Why is it that Governments (of all political persuasions) will not listen to those in the know and who have to ‘work the system’? They were warned by enough ‘bodies’ reperesenting doctors! Do they not believe that people can be sick ‘out of hours’? Maybe the whole profession should provide an ‘emergencies only’ service - which would eat up most of the 48hrs - and then see what is left for ‘elective’ cases.
Retired Orthopaedic (and Trauma) Surgeon