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Catch-22 'forcing medics to work over legal hours'

By Lisa Smyth

The NHS in Northern Ireland is facing a staffing crisis as it emerges hundreds of junior doctors are working longer hours than European health and safety laws allow.

In August 2009 new legislation came into force across Europe — European Working Time Directive (EWTD) — stating that no-one can be forced to work over 48 hours a week.

Under the legislation employees can volunteer to opt out of EWTD, but cannot be forced to do so. However, a leading doctors’ union has claimed junior doctors are being left with little option but to agree to work longer than the 48-hour limit.

Figures obtained by the Belfast Telegraph under the Freedom of Information Act reveal that of the 2,000 junior doctors employed in Northern Ireland, at least 263 are working outside of EWTD.

The doctors’ union has said they demonstrate that health bosses are still failing in their responsibility to protect patient and staff safety.

Dr David Farren, chair of the British Medical Association’s (BMA) Northern Ireland Junior Doctor committee, said: “These figures are very worrying and worse than I thought they were.

“EWTD doesn’t just protect patients from overtired doctors, but it also protects junior doctors from getting injured themselves in an accident as a result of being tired.”

Staffing issues have emerged in Northern Ireland as a result of the introduction of EWTD, meaning more doctors are required to cover the same number of rotas.

The problem has also been exacerbated by new immigration laws making it harder for international doctors to come to the UK to work.

In September 2009 staff shortages became so severe that the obstetric and gynaecology service at the Erne Hospital was suspended for a number of weeks due to a lack of junior doctors.

According to the figures obtained by the Belfast Telegraph, there are currently 108 vacancies for junior doctor posts in hospitals across Northern Ireland.

In the Belfast Health & Social Care Trust, 64 junior doctor posts are empty — a total of 10% of the junior doctor posts in hospitals in the trust. The greatest number of vacancies are in surgical and medical specialties, with 22 and 21 respectively.

The figures also show that 158 of the 773 junior doctors in the trust are working longer than the 48-hour week set out under EWTD legislation.

However, this must be voluntary, put in writing and cannot be an agreement with the whole workforce. At the moment there is no formal procedure in the trust for junior doctors to opt out of EWTD. It is assumed that by working over the 48 hours, junior doctors are accepting the opt-out.

Dr Farren said he does not believe health bosses are doing enough to address staff shortages.


In August 2009 new European legislation — EWTD — was |introduced restricting the length of time junior doctors |can work each week to 48 hours, meaning more staff are required to fill rotas.

The suspension of services at the Erne Hospital in September 2009 left some women in southern parts of Co Fermanagh facing a round-trip of more than 100 miles for routine appointments when efforts to appoint six junior doctors saw just one taking up a post.

Belfast Telegraph


From Belfast Telegraph