DH turns a blind eye to working time rules

The DH has stopped monitoring whether trusts are complying with the directive, which restricts workers to a 48 hour working week and was extended to junior doctors last August. It is estimated to cost the NHS hundreds of millions of pounds each year.

While trusts are still officially responsible for complying with the European regulations, no data has been collected centrally since the new government came to power.

A DH spokesman said this “will limit the impact of the working time directive in the NHS”.

Royal College of Surgeons president John Black told HSJ trusts were increasingly taking their lead from the DH move and reducing compliance with the directive. He said: “They [trusts] realise it’s an endgame and there isn’t any point in carrying on anymore.”

The coalition government is hoping to revise the agreement. At a fringe event during last week’s Conservative Party conference, health secretary Andrew Lansley said he was “absolutely determined” to secure a “new settlement”.

He said he hoped to reach a deal that “retains our opt-out and gives us, if possible, the opportunity for a disapplication [of the rules] in certain areas of the NHS”.

He added: “It’s important to arrive at a new position where junior doctors get the experience [so] they and their patients are confident they will be treated by someone who has suitable experience.”

Government impact assessments carried out before the directive was imposed put the annual cost of implementation at £380m-£780m in 2004 prices.

The figures were given in response to calls from MPs to establish the “worst case scenario” of having to employ 6,000-12,000 extra doctors to cover staffing gaps created by implementing the directive.

Last year primary care trusts were allocated £310m of specific, non-ringfenced funding to support compliance such as buying new IT systems. Not having to comply with the directive could also make a major contribution to the NHS savings target of £15bn-£20bn by 2013-14.

Speaking at a separate Conservative fringe event last week, KPMG global head of healthcare Mark Britnell advised trusts to “gently ignore” the directive as, he claimed, most other European countries were already doing.

There is fresh evidence that trusts are reducing compliance with the directive.

In an annual survey of trainee doctors published by the General Medical Council this week, two thirds of the 41,450 respondents claimed to regularly work beyond 48 hours a week.

One in 10 said they had felt pressured to wrongly record that they had complied with the directive.

This is despite the fact that, on paper, deaneries - which oversee junior doctor placements - claimed they were on average 84 per cent compliant with the directive in the last year.

The GMC survey also shows that 17 per cent of trainees had been asked to opt out of the 48 hour working week, although only 11 per cent did so.

Junior doctors associated with the Northern deanery were most likely to say they had signed an opt-out without being asked to do so.

NHS Employers head of medical pay and workforce Bill McMillan warned trusts taking advantage of hours made available through opt-outs risked breaching the terms and conditions of the junior doctors’ contract.

He claimed that compliance with the directive was “very widespread”, and that trusts were still monitoring the working hours of juniors, despite the fact that ministerial returns had stopped.

A DH spokesman said: “This government committed in the coalition agreement to limit the application of the working time directive in the UK.

“It is essential that the ability to opt out of the 48 hour working week is retained, and that a workable solution is found.”

GMC chief executive Niall Dickson said there was a danger trusts would cut education budgets at a time when the directive was leaving junior doctors with less time for on-the-job training.