EU laws will Bring Chaos to Hospitals, Say Doctors
by Celia Hall

Hospitals will grind to a halt when European rules on young doctors' working hours come into force next year, the British Medical Association has warned the Government.

Thousands of hours will be lost to the National Health Service when 40,000 junior hospital doctors switch from a 72-hour week to a 58-hour week in line with the European Working Time Directive (EWTD) which comes into force in August 2004.

The Department of Health admitted yesterday that the requirements were "challenging" especially for small hospitals. James Johnson, the chairman of the BMA, told The Daily Telegraph that the rules would lead to the closure of hospital departments and the cancellation of waiting list cases.

"These are the doctors who, in this country, form the backbone of the residents system. It is a big jump from 72 to 58 hours. A huge number of doctors working hours will be taken out of the system. As things stand, it is hard to see which departments hospitals will be able to keep open," he said.

The BMA is having talks with ministers about the impending crisis and Professor Carol Black, the President of the Royal College of Physicians, has also written to the Government on this issue.

The College conducted is own survey of 211 hospitals and found that 116 do not have sufficient numbers of specialist registrars - the doctors in training - to make up new rotas based on the shorter working week.

The College would like the EWTD for junior doctors put back but the BMA believes it should come into force on schedule. Under the changes, the total hours doctors work will be counted differently. From next year all time spent on hospital premises will count, regardless of whether doctors are with patients or asleep on call. Previously sleeping time was not counted.

Mr Johnson, a vascular surgeon from Cheshire, and a former chairman of the BMA's junior doctors' committee, said; "The junior doctors are the main doctors who are resident at nights and weekends. Because of a European Union ruling, it won't matter if you're fast asleep and not working. What will happen next August is a very good question. We are going to have to do something imaginative now if we are not going to have a bit of a disaster."

Doctors asked to work longer hours to plug gaps would be able to take legal action, Mr Johnson added.

"If they don't sort this out, the junior doctors are going to take them to the cleaners under European health and safety legislation," he said. "Trust will have no choice but to close wards down. When you have a melt down in the NHS, all you can do is to stop elective (waiting list) work and give the priorities to the emergencies."

He said that a "knee-jerk" solution would be to consolidate the hospital into a smaller number of larger hospital centers. But that had been ruled out by politicians and the public who like local hospitals even if they were "a few percentage points less safe."
A spokesman for the Department of Health said that the directive did necessitate new ways of working.

"It's a challenge and we will be looking for solutions to improve the quality of care and maintain access to patient services wherever possible," he added.
The Daily Telegraph, 14th July 2003