A shortage in the number of junior doctors working in Northern Ireland will ultimately affect the quality of patient care in our hospitals.
That's the warning of the British Medical Association (BMA) which has written to the chief executives of our five Health Trusts asking that the situation be urgently addressed.
Chairman of the BMA's junior doctors committee in Northern Ireland, Dr Rajesh Rajendran, told the health chiefs that junior doctors are being pressured to "work excessive hours to fill gaps in ward rotas, often without additional pay".
"In some cases there can be as many as four unfilled vacancies in certain specialties which substantially increases the workload of the remaining doctors," he said.
"It appears that hospitals are frequently unable or unwilling to find locums to fill positions and pressure is then put on the remaining juniors to work extra shifts, often single-handedly."
"We believe that, in some cases, the quality of patient care is being put at risk."
"Many doctors believe that their careers would be on the line if they tried to resist providing the extra unpaid hours; consequently they are reluctant to speak out."
In his letter to the trusts, the doctor reminded them that the deadline for implementation of the European Working Time Directive "is now fast approaching and this problem can only increase if not addressed now; from August 2009 the official working week will be further reduced from 56 to 48 hours".
A recent BMA poll of junior doctors in the UK showed that 29% are working on a rota with at least one vacancy. Of the respondents who reported vacancies, most said there were one or two doctors missing but some reported four or five. The BMA said that gaps in hospital staffing rotas are now appearing whenever a junior doctor gets promoted to consultant, or leaves for other reasons.
The BMA has issued guidance to junior doctors advising them to watch for changes in their rota patterns and warning that the problem could result in " increases in stress, bullying, and harassment".