TURLOUGH O'DONNELL,
Sir, - I have listened with complete horror to the Minister for Health's recent outbursts after a long period of silence on the current NCHD dispute. If the Minister can crystallise this issue down to one of junior doctors avariciously trying to protect their long hours in order to maximise overtime pay, then he has displayed an alarming ineptitude in grasping the core issue involved.
The concept of "junior" doctor is a misleading one. After graduation, doctors begin training in chosen specialist fields. This can take up to 15 years in some surgical specialities to become a consultant. For this entire period of time, one is known as a "junior" doctor. As well as providing the service commitment to the job, doctors are also expected to be trained, as part of their everyday routine. This involves doing postgraduate diplomas and degrees, being involved in research, training medical students, attending courses and lectures, and receiving personal one to one training from one's consultant. The bulk of this training takes place in the 9 a.m. to 5 p.m. period.
What the health boards have tried to unilaterally impose on NCHDs is a duty roster which, while providing a 40-hour week, requires most of these hours to be worked outside of the 9 a.m. to 5 p.m. period.
This has massive implications for training. The HSEA says that it is honouring the 2000 agreement with the IMO to reduce working hours in line with European directives. This is disingenuous in the extreme. The HSEA is motivated by money, pure and simple. It has no concern over NCHD training, and, by implication it has no concern about the quality of healthcare being delivered.
"Junior" doctors have no desire to work more than 40 hours a week, but this had to be in the context of working within a 9 a.m. to 5 p.m. framework when training is taking place. This issue is at the core of NCHD training, and if the Minister chooses to ignore this for the sake of pandering to the money men in the HSEA, and currying favour with a public who seem tired of healthworker industrial disputes, then he has displayed an incompetence on a par with most of his predecessors in health, and should resign immediately. - Yours, etc.,
TURLOUGH O'DONNELL, MB, BCh, FRCSI, Rathfarnham, Dublin 16