New rosters in hospitals 'will reduce services'

The introduction of new rosters in hospitals to allow for reductions in the working hours of non-consultant doctors will lead to major reductions in services for patients and increased waiting lists, the national co-ordinator for implementing the EU directive has warned the Department of Health.

Under the new EU Working Time Directive hospital doctors will not be allowed to work more than 58 hours a week averaged over one year.

The directive came into force on August 1st, but the Government said it would not introduce new rosters unilaterally pending talks between employers and the Irish Medical Organisation at the Labour Relations Commission. These are due to resume later this month.

However, The Irish Times understands that in recent months the national co-ordinator for implementing the directive, Mr John Bulfin, has warned the Department of Health that the introduction of the 58-hour week would require "significant resources" and was likely to have a major impact on services.

"From my discussions to date with senior managers and medical manpower managers it is clear that, while it is possible to produce rosters that will be technically compliant with the directive, the effect on services should not be underestimated.

"This is not surprising as the number of non-consultant doctors available during the core day will be significantly reduced," Mr Bulfin said in correspondence with the Department of Health last April.

He said that the likely effects of the directive included:

a reduced number of out-patient clinics

reduced elective surgery

increased waiting lists for outpatient and elective surgery

increased length of stay resulting in longer delays in casualty, delayed admission and a back-up of discharged patients on the wards.

"In certain settings, full compliance from a legal perspective would result in emergency services only, with outpatients restricted to review of discharged patients only," Mr Bulfin wrote.

He forecast that significant resources would be required to implement the directive.

"Additional consultants/

NCHD appointments together with extra nurses for cannulation/IV teams as well as phlebotomy services have already been flagged," he said.

The national co-ordinator said the greatest challenge presented by the directive was at smaller hospitals where the number of NCHDs and consultants was limited.

Mr Bulfin said it would be extremely difficult to proceed in producing rosters that were compliant with the directive if the Department of Health ordered that there was to be no impact on services for patients.

Mr Bulfin also appeared to cast doubt on recent claims by the Taoiseach and the Minister for Health, Mr Martin, that 60 per cent of hospitals around the country would be able to comply with the directive.

"I am aware of recent statements to the effect that there is 60 per cent compliance around the country with the European Working Time Directive. From my visits to date and my discussions with medical manpower managers, I believe that this only applies when one excludes the rest period elements of the directive. The compliance levels are much lower when the 13-hour rest period is taken into account", Mr Bulfin told the Department.

A spokeswoman for the Department told The Irish Times last night that the Minister had insisted that patient services should not be affected. She said he believed that a way could be negotiated to comply with the directive and at the same time maintain services.