48-hour working week will risk patients’ lives

Surgeons have told Channel Four News at Noon that patients' lives could be at risk if new regulations restricting the number of hours doctors can work come into force – as planned this summer – as they will drastically cut down training hours for junior doctors.

A survey of consultant surgeons – seen exclusively by Channel 4 News – reveals 78% feel that complying with a 48-hour week has already had a detrimental affect on the training of surgeons, and nearly two thirds feel it has been at the expense of patient care.

While some professions remain exempt from the European Working Time Directive the Government has decided that trainee doctors should be covered by the rules from August this year, despite widespread resistance. However, the 48-hour working week has already been introduced by the strategic health authority in the North West of England as a pilot scheme.

The results of the survey (of those respondents whose service / speciality is currently compliant with the 48-hour week) showed:

• 78% of respondents believed that “compliance had been at the expense of core trainees’ training”;
• 70% thought “compliance had been at the expense of speciality trainees’ training”;
• 63% thought “compliance had been achieved at the expense of patient care”; and
• 50% thought compliance had been “achieved by filling gaps on rotas with staff already employed in the Trust”.

Ben Cresswell, President of the Association of Surgeons in Training (ASiT) told Channel 4 News: 

“The ultimate fear for doctors in training and for qualified doctors is that we'll be left with a less experienced and less well trained workforce,” adding that as a consequence, “patients may suffer serious harm or death as a result of either a misdiagnosis or a delayed diagnosis."

For a profession that has been known to work in excess of 100 hours a week, cutting that down to 48 could result in training hours being halved. The Royal College of Surgeons believe that trainees need to work up to 65 hours a week to cope with their work load and get adequate training. The Department of Health said it will only consider allowing some doctors to work up to 52 hours a week in extreme circumstances, but not 65.

A trainee who wished to remain anonymous spoke to Channel 4 News about how little training he gets:

"I have such a lack of skill at the moment that it concerns me.  I've got six and a half months before I'll be expected to do a certain amount of key operations like half hip replacements and fixing of wrist fractures.  In six months time I wouldn't send my grandmother to me to do an operation."

Dr Yasmin Ahmed-Little of the North West Strategic Health Authority said:

“Patients will be safer with rested doctors. At the end of the day, we are in a situation where these same patients wouldn't get on a plane if the pilot had worked some of the hours that our doctors have worked and are currently still working.”

Reproduced with kind permission from Channel Four News at Noon.