Published: 04/03/2004, Volume II4, No. 5895 Page 7
Trusts will have 'severe difficulties' complying with European limits on doctors' hours, a parliamentary inquiry was due to hear yesterday.
The NHS Confederation was scheduled to give evidence to a House of Lords inquiry which warns that some trusts may have to break the law if they continue to run round-the-clock services across obstetrics, paediatrics and anaesthetics.
It is so concerned about the impact of recent EU rulings on doctors' hours that it has written to the European commissioner for social and economic affairs asking for the law to be softened.
Under the EU working-time directive, from August junior doctors' hours must not exceed 58 per week. The confederation is concerned that Brussels is interpreting the law too tightly in the wake of the recent landmark Jaegar and SIMAP cases by stipulating that time spent asleep during resident on-call counts as working time.
Speaking to HSJ before giving evidence to the inquiry, Alastair Henderson, now acting director of the confederation's employers' organisation, said he wanted to see a more flexible approach.
'We are supportive of the intent of the directive because we recognise there are safety issues around long working hours.
'But we are asking the commission to recognise that on-call time is slightly different from active working time.'
The 58-hour limit means rotas which now only need five or six doctors will from August need up to 10 doctors - more staff than many hospitals have available, according to the confederation.
This is why some trusts are phasing out resident on-call and switching most junior doctors onto shift arrangements instead.
Giving evidence to the inquiry yesterday, the confederation was due to welcome the directive itself, but to warn of 'real concerns about the implications of the SIMAP and Jaegar judgements'. It will also predict that rural district general hospitals will have severe problems complying with the directive.
The only way such hospitals can provide a safe standard of care and meet the directive's criteria will be to reconfigure services, the confederation points out, which local populations may oppose.
But reconfigurations could be seen as undermining the government's claims that it wants to keep the NHS 'local' after guidance published in the wake of political rows over the downscaling of acute services in Kidderminster.
Last week the British Medical Association told the inquiry, being held by a subcommittee of the Lords' social and consumer affairs committee, that the Department of Health is in denial about the impending workingtime 'crisis'.
Speaking at the same hearing, the TUC said the Health and Safety Executive should have enhanced powers to 'blitz' employers suspected of operating a long-hours culture instead of relying on complaints from disgruntled staff.
The TUC said the European Commission should impose a blanket ban on working over 48 hours a week, with no possibility for individuals to opt-out.
A blanket ban would mean that nurses could no longer notch up more than 48 hours a week through bank and agency shift.At current levels, three out of four consultants would be breaking the law.
The parliamentary inquiry is due to report by the end of March and will feed into an EC consultation on the directive.