Dublin hospitals at risk from EU directive

Doctors' hours: A number of hospital units in Dublin will be "absolutely threatened" by the implementation of the European Working Time Directive (EWTD) which limits the working hours of non-consultant doctors, a Dáil committee has been told.

The claim was made by the chief executive of the Health Service Executive, Prof Brendan Drumm, last week.

Appearing before the Dáil Public Accounts Committee, Prof Drumm said it could affect particularly the future of surgery for children in Dublin which is currently carried out at Temple Street, Crumlin and Tallaght hospitals. He said that to meet the terms of the directive - which was the driving force behind the controversial Hanly Report on hospital reforms - there would have to be seven non-consultant doctors on each consultant team.

The EWTD, which came into effect in August 2004, set a limit of 58 hours per week for non-consultant doctors. This will be reduced on a phased basis in the years ahead to 48 hours per week. One of the aims of the Hanly Report was to provide a blueprint for services to live within this structure.

Prof Drumm said that many people believed that the Hanly Report would focus on the north- east and the mid-west regions.However, he said it was also hugely important for Dublin.

"Units will be absolutely threatened by the EWTD. In my own specialty, paediatric surgery across three sites cannot easily be justified should we need seven people for each team," he said.

The secretary general of the Department of Health, Michael Scanlan, told the committee that in his view the Hanly Report was still Government policy.

He said that whether it was called Hanly or given some other label, the key core message had been around for many years. He said that to his understanding, this agenda was the agenda of the health service "whether you call it Hanly or call it what you will".

Prof Drumm told the committee that to deliver quality health services, the interest and needs of the patient must be put ahead of all other considerations.

"I appreciate that members of the Oireachtas are constantly subject to natural constituency demands and often come under significant pressure from the community to support local services that may appear perfectly logical and reasonable, but may not be sustainable from a clinical perspective or may not reflect international best practice," he said.

Prof Drumm said that within the community the HSE would be seeking "to shift people away from thinking that if they do not attend a hospital they will not get the best care".

"This will require a greater emphasis on developing primary and community care systems which must become more integrated and be based on specific geographical areas."

Prof Drumm defended his recent comments that the country was over-equipped with hospital beds but that it did need additional community facilities.

He said he would engage with the Tánaiste Mary Harney to use some of the health budget to build up community services.

He said he wanted to focus on the development of a seven-day working week in community services but that it could take two years to reach agreement with staff and unions.