City Doctors still work for too long

Swansea hospital doctors are still working over-long hours six months after new European rules kicked in to shorten them. The European Working Time Directive (EWTD) came into force last August, limiting doctors’ hours to 58 a week, and reducing further to 48 by 2009.

It is aimed at making sure medics are rested between shifts. Some doctors have been working twice that.

But even though hospitals were given several years’ notice of the change in the law, many were not ready.

Last summer Swansea NHS Trust said it was between 60 and 70 per cent compliant just weeks before the deadline.

But now, six months on, it has apparently made little progress, and is stuck at 60 per cent.

It is now working with the Assembly on a Hospital at Night project which gets around EWTD rules by reorganising the way hospitals work when patients are asleep.

Bro Morgannwg NHS Trust is another looking into the scheme.

A spokeswoman for the Swansea trust said: “The trust is approximately 60 per cent compliant with EWTD requirements for medical staff.

“Over recent months our efforts have focused on a major data collection exercise capturing hospital activity at night.

“The data will enable informed decisions to be made regarding where additional investment is required to increase overall compliance.”

Former Singleton gynaecology registrar Jo Hilborne, deputy chairwoman of the British Medical Association’s national junior doctors’ committee, said: “For people who say the directive isn’t needed, I’d ask patients who they would prefer to treat them - a doctor who has worked very long hours, or one who has had a rest.”

She warned that the Hospital at Night scheme was not the whole answer.

“Paediatrics and obstetrics don’t fit well into it,” she said. “The scheme is basically a team of doctors who will cover all emergencies through the night, and allow specialists to stay at home, off duty.

“But paediatrics and obstetrics are difficult to cover without specialists.”

The dilemma is a particular problem at Singleton, where the city’s main children’s services are based, along with the maternity unit.

But Morriston is also affected to a lesser degree.

The Swansea trust is now looking at taking on both extra specialists and non-medical staff so workloads can be shared to cut the hours doctors work.

By December, only seven of the 15 Welsh NHS trusts were fully compliant, translating into an overall rate of 75 per cent.

Morriston anaesthetist Adam Brown joins the Assembly’s team as junior doctor co-ordinator from Monday to help advise officials. A report to the Assembly’s health committee said: “All trusts and health boards have been asked for an update on their detailed plans and the steps being introduced to meet the directive.”

A spokesman for the European Commission in Wales said: “Policing of the directive is the responsibility of the member state. In this case, because health is devolved, it is up to the Assembly.”

Provided by ArmMed Media
Revision date: July 4, 2011
Last revised: by Jorge P. Ribeiro, MD