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Saturday, 21 January 2012

Safeguarding doctor training and patient care

This week I had a PMQ ( Prime Minister's Question) about the effect of the European Working Time Directive on the NHS. It may sound a bit techie, but it's absolutely crucial.

Growing up with my dad as a surgeon in the NHS ( He worked at Southmead Hospital and the BRI for 30 years, and may well be responsible for any hip replacements or hand surgery of constituents reading this...) has given me a special regard for the professionals working in our NHS, and a particular perspective on the importance of what goes on at the coal-face of our public services.
One of the things that Doctors tell me about again and again is the devastating effect that the 48hour European Working Time Directive has both on doctor training ( the Royal College of Surgeons estimates that because of the Directive 400,000 surgical hours are lost PER MONTH) and also on patient care. ( all the 'clock-on, clock off' handovers mean that important bits on patient notes can get missed, and the poor patient is subjected to a conveyor belt of different doctors, instead of a few familiar faces of the doctors responsible for them.)

The directive limits doctors to working up to 48 hours per week, and takes away crucial flexiblity. No one wants to return to a situation where junior doctors are working silly hours and are too exhausted to practice safely. But there is a middle-way. The Royal College of Surgeons suggests that up to 65-hours a week is suitable, but with flexibilty to meet the unpredictable realities of hospital care.

And guess what: there are no special provisions in the directive for exceptional circumstances like a 'flu pandemic - so it is hard to see how in this scenario, the NHS will have the flexiblity to cope. (More on this in a recent article I wrote for The Times on 20th Jan.)

I presented a bill to Parliament to try to tackle it,

have written in the national papers on the issue, and am working hard to try and untangle this mess of an EU Directive which is putting our NHS, and patient care at such risk. Government is supportive, but it must act quickly. Because whatever the structural reforms, the future of our NHS and the patients it cares for depends on the medical professionals who work there.


Luke said...

65 hours a week seems quite long too. What sort of hours would junior doctors be found to be doing in the bad old days?

Charlotte Leslie said...

It could be north of 100 hours a week, which was dangerous and silly. No one wants a return to that. Clinicians suggest that 65 hours strikes the right balance between sufficient training time and rest period.