Madam, - The European Working Time Directive aims to reduce the hours of junior hospital doctors to an acceptable level. This is an important task, but the manner in which it is undertaken will have substantial implications not only for doctors' training but also for patient care.
From both perspectives, the introduction of an exclusively shift-based system would be an error.
People attending outpatient clinics often lament the fact that junior hospital doctors change over every six months. In an exclusively shift-based system, hospital doctors may change over every six hours.
The possibility of a consistent, personal relationship with your hospital doctor, even for five consecutive inpatient days, will be remote.
Continuity of care will decline; quality of care will fall.
Poorly trained doctors, discontinuity in the therapeutic relationship, and declining quality of care: is this in anyone's interest? - Yours, etc.,
Dr BRENDAN KELLY, Islandbridge, Dublin 8.