The president of the Royal College of Surgeons says there is now the “political will” to tackle the 48-hour week and its damaging effects on training.
Mr John Black said, in the college bulletin, that he had recently spoken to the new health secretary Andrew Lansley and suggested he was sympathetic to the college’s campaign against the WTD.
He said: “The Secretary of State for Health assured me that he has given sorting out the problems produced by the EWTR a very high priority. He is well aware of the current crisis it has produced in the NHS, with deteriorating patient care and seriously compromised training. He knows the massive cost to the NHS, with in one trust 15% of the medical staff budget going to pay for locums for rota gaps that would not exist with a sensible hours regime.
“I told him that there could be no better way for the new government to get surgeons (and I suspect many other doctors working in acute care) on their side than to remove the restrictions of the EWTR.”
Last week, the Temple review acknowledged there are problems with access to training but suggested they would not be eased by either increasing trainees’ work hours beyond 48 hours nor lengthening training programmes.
Instead, the review suggested that rota gaps can only be overcome with a fundamental change in the way training and services are delivered. It says that, despite a 60% increase in consultant numbers over the past 10 years, hospitals remain reliant on juniors to provide out-of-hours services.
Chair Sir John Temple recommended a move to a consultant delivered service, with seniors more directly responsible for the delivery of 24/7 care.
Black said the health secretary has several options to lengthen juniors’ training “including UK primary legislation, a formal sector opt-out within the current European law or a modification to the EU Social Chapter”.
He continued: “The new foreign secretary, William Hague, has indicated publicly that the EU should not set junior doctors’ hours of work. As I have said throughout what is needed is political will and this is now there.”
He said: “The key, given removal of the legal restrictions, is a contract for junior surgeons based on training, with hours worked becoming secondary. Proper hands-on training should become a contractual commitment from employer to trainee. Properly drafted new rules would stipulate team working (the old firm structure), which would restore continuity of care to patients.
“We look forward to working with Mr Lansley to achieve this and it is very good news that he understands the urgency. There are many difficulties to overcome but at last we are moving in the right direction.”
Earlier this year a BMA survey claimed that half of juniors were missing out on training opportunities following WTD implementation.
how wonderful. let them do all the hours they want - until one fine day smthg goes wrong - which, due to murphy’s law, it will - and the patient affected will get a really sharp lawyer. the doctor who is then found to have treated that patient in his 80th working hour that week, after a busy 24 hour on-call and no proper sleep (like every week) will have an interesting time in court. he/she will have to prove that he/she is a safe pair of hands doing surgery despite working times that are considered unsafe for truck divers. enjoy! all the grandees who are now working so hard to get them docs back into the 80 hour week will be invisible that moment, the one caught out will be all on his/her own … some are determined to learn the hard way only - let them lemmings jump off the cliff, they want to, in the name of “training”.