Britannia Radio

""In those circumstances arrangements which offer a 
derogation of up to 52 hours work per week for a limited time are 
being considered, subject to EU approval."

So what if EU approval was not forthcoming?  MPs would have a choice:

1. Remain loyal to the EU and uphold the purported primacy of EU law, 
even though some of their constituents might die as a result; or

2. Re-assert the supremacy of Parliament, and disapply the EU law.

I think I already know which option they'd choose - and it would make 
precious little difference whether the majority of MPs were Labour, 
or Liberal Democrat, or Tory."

My initial reaction was the same except that the one thing that 
stands out a mile to me is that the Krauts have a sensible 61 hr opt-
out!  If so then the ONLY reason we can't have it surely is our own 
government .  Or have I missed something?

The reply from the NHS Employers at the end is excruciatingly 
ignorant and awful.  There'll probably be enough proper doctors 
around for the rest of my life, but id you're under about 70 LOOK OUT 
for yourselves for the EU aided by our government is wrecking the 
practive of medicine in whatever form including the NHS.

xxxxxxxxxx cs
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TELEGRAPH   23.1.09
Cuts to trainee surgeons' hours threaten patient safety: Royal 
College of Surgeons
Trainee surgeons are under pressure to falsify their working hours 
and are operating on days off as hospitals struggle to comply with 
cuts to working hours, the Royal College of Surgeons has said.
by Rebecca Smith, Medical Editor


Junior doctors should be allowed to opt out of the European Working 
Time Directive that limits them to a 48-hour working week from August 
because the effects on patient care will be 'disastrous', John Black, 
president of the College said.

Patients are being put at risk and the quality of their care is under 
threat as many hospitals are covering up failures to implement new 
rotas that comply with the directive, the Royal College has warned.

The College is calling for the Government to agree an opt out to 
safeguard patient safety and highlighted that in America juniors work 
an 80-hour week and in Germany a 61-hour week has been agreed.

The College also wants the on-call rule to change so sleeping at 
hospital does not count towards the working hours as it does currently.

Concerns were raised over junior doctors hours as many were working 
up to 100 hours a week and were making mistakes because they were so 
tired. Now the working time directive threatens to cut juniors hours 
so much that they cannot get enough experience to practice safely, it 
has been argued.

A survey of over a thousand surgeons by the Association of Surgeons 
in Training (ASiT) found more than half of trainees felt under 
pressure to falsify their hours.

Nine in ten were regularly exceeding their rostered hours, 85 per 
cent were coming in on days off to carry out operations and seven out 
of ten said the reduction of their hours so far has not improved 
their worklife balance.

ASiT believe 65 hours a week is required to gain the necessary 
training opportunities and 80 per cent of respondents would support 
an opt-out of the European Working Time Regulation to protect training.

Only a quarter of junior surgeons felt that the records of their 
working hours held by their trust's human resources department 
accurately reflected their actual hours.

A further survey of almost 500 surgeons found unsafe levels of 
staffing because there are not enough surgeons available to fill 
rotas and gaps are appearing.

Over half of those questioned had experienced gaps on their rota. NHS 
Trusts are now routinely re-employing their own trainee surgeons out 
of hours as "internal locums" to cover gaps in shifts - with over two 
thirds of rota gaps filled in this way.

Two thirds of trainees working with rota gaps feel that patient care 
has suffered as a result.
"This is a worry for today and tomorrow," said John Black, President 
of the Royal College of Surgeons. "On the one hand, the immediate 
effects on patient care in the NHS are potentially disastrous.
"There are simply not the surgeons in the UK to fill the gaps when 
every doctor's hours are cut to a 48 hour per week maximum. On the 
other, trainees are telling the college they cannot gain enough 
experience to progress on the shortened hours.
The choice for the nation is clear - do we want patients of the 
future to be treated by a group of highly skilled and experienced 
surgeons; or be passed around a wider group of lower skilled surgeons 
with less experience?"

Alastair Henderson, joint director, NHS Employers, said: "Increasing 
junior surgeons' hours would be a backward step.
"NHS employers have worked hard to implement the directive and have 
made good progress. More than half of junior doctors are already 
compliant and employers are still committed to ensuring that the 
maximum number of doctors are compliant by August 2009.
"We recognise, however, that there are a small number of services for 
which compliance may not be possible by August 2009. In those 
circumstances arrangements which offer a derogation of up to 52 hours 
work per week for a limited time are being considered, subject to EU 
approval. In these circumstances there would be rigorous scrutiny of 
the services affected and these would include plans to achieve 
compliance as soon as possible.

"We are not aware of any evidence that junior doctors are being asked 
to falsify their hours. If any doctor is being pressurised or bullied 
into falsifying their monitoring returns they should raise the issue 
with their HR department or trade union so that this can be 
investigated."

[This NHS employers' reply is a scandal in  itself.  It doesn't 
answer ANY of the points raised and merely illustrates the folly of 
letting unqualified and incompetent managers anywhere near clinical 
decisions. -cs]