Tough new regulations governing junior doctors’ working hours have brought major operational changes and forced hospitals to review working practices on the wards.
But health bosses and academics believe that the European Union’s Working Time Directive could make the health service more efficient and lead to a more highly skilled workforce.
In August, the Working Time Directive, which puts a 48-hour limit on average weekly working hours, was applied to junior doctors with the restrictions to be phased in gradually. The phase-in started with the introduction of a 58-hour week, falling to 56 hours by July 2007 and 48 hours by July 2009.
Junior doctors can opt out of the time limits and employers must keep a record of who has agreed to work longer hours. However, the European Commission is consulting on whether the directive needs to be amended in this area.
Under the new regulations the working time limits include all the time junior doctors spend resident on duty, irrespective of whether they are sleeping or working.
Employers breaching the rules can be fined up to £5,000 by the Health & Safety Executive and taken to employment tribunals by junior doctors.
Stephen Brown, partner and head of the employment and benefits team at London-based Latham and Watkins, says: “The crucial matter is whether junior doctors’ rest time and the time spent in their rooms is going to count towards their working hours and whether this can be challenged.
“Assuming the opt-out is available by law, how many doctors will sign up for it? It may be that junior doctors’ training will have to be lengthened or there will have to be faster training. The other option is to recruit more doctors,” Brown says.
“Junior doctors’ hours have an impact on staffing rotas and I can’t see a simple way round that,” he adds.
Employment Lawyers Association chairman Raymond Jeffers says: “Whether the opt-out clause stays or goes is a political question. There was a time when it seemed the opt-out would go because other European countries are not interested in it. But now it could go a number of ways. The EC states that the opt-out might be kept but there might be strict conditions to follow.”
The issue of whether time spent “on call” counted towards working time was tested in the European Court of Justice in the cases of Landeshaupstadt Kiel v Jaeger and the Spanish Sindicato de Med