Madam, - The Collegiate Members Committee is composed of non-consultant hospital doctors ("junior doctors") within the Royal College of Physicians of Ireland, a body which strives to promote high standards of training and clinical practice amongst physicians.
We wish to publicly restate our support for a reduction in working hours for NCHDs. The EU Working Time Directive has the dual aims of protecting patients and improving the welfare of doctors working within our health service. Properly implemented, these goals are achievable. However, we are deeply concerned that current plans to reduce the working hours of doctors by August 1st will achieve neither of those core goals and that a precipitate and ill-planned effort to implement the directive in the next few weeks will have grave consequences for patients and doctors alike.
The results of several surveys and reports by the Royal College of Physicians in the United Kingdom should leave us in no doubt as to the impact of the widespread adoption of shift working by doctors in training. These highlight a worrying reduction in the quality and continuity of patient care and opportunities for training following the introduction of shift work.
The consultant has become the sole provider of continuity of medical care for patients in the UK system. This is a far from satisfactory situation for patient care.
Furthermore, we do not believe that with the relatively much smaller number of consultants in our system, our senior colleagues would be able to compensate in a similar way. In short, we believe that the widespread adoption of shift working for NCHDs, without a significant immediate expansion in consultant numbers, will represent a real and tangible danger to patient safety.
In addition, it is vitally important that training standards are maintained in order to equip current NCHDs with the skills necessary to be effective future consultants. We wish to inform patients of our concerns and place these on the public record.
The directive presents an ideal opportunity to reform working structures for the benefit of all concerned. Given that it has been anticipated for well over a decade, the progress towards its implementation to date is very disappointing.
In particular, the efforts by the Government to reduce the issues involved to a wrangle about overtime payments are unhelpful and constitute an attempt to divert attention from the failure to prepare effectively for the implementation of the directive.
We believe that a properly planned, phased introduction of this directive should form a core part of the restructuring of our health service.
However, if the fundamental spirit of the directive is sacrificed for a "quick fix" effort at implementation, we foresee a crisis in patient care and in the professional development of doctors, which will inflict irreparable damage on our health care system. - Yours, etc.,
Dr GLEN DOHERTY, Chairperson, Collegiate Members Committee, Royal College of Physicians of Ireland, Hatch Street, Dublin 2.