The Working Time Regulations (WTR) implemented by the EU in 2009 has been subject to a lot of negative feedback recently. The directive, which limits doctors to working 48 hours per week has not been received well since it was implemented in 2009. However, of late, doctors have been proactively encouraged to opt out of the directive. There has even been talk of opting out of all the EU social and employment legislations in place currently.
Are we heading back to square one as junior doctors are encouraged to opt out of the EU directive and do longer shifts? That’s the question that’s on many of our minds. The reasons why the initiative was brought into effective in the first place should not be forgotten. Doctors were working over 100 hours per week which in turn had a negative impact on their performance. Tiredness and fatigue were a direct result of the excessive working hours.
Logically, one would think that reducing the number of hours worked would reduce fatigue and stress. Conversely, it’s been claimed that the reduced working hours have increased fatigue due to poorly organised rotas and shift patterns. An article in the Telegraph concurred that the new hours were exhausting to work and were unbalanced from week to week. But it appears that the problem is not the directive in place but rather the way in which it is being implemented. Perhaps better planning and organisation would resolve these problems, as opposed to encouraging doctors to start working long hours again which could be detrimental to patients.
Moreover, despite the fact that many of these articles give the impression that most junior doctors are unhappy about the directive, this may not be the case. The BBC highlighted a recent survey which found that 82% of young doctors struggle with the excessive hours they work. This was backed up by a piece written by a junior doctor in the Telegraph which highlighted that many doctors complained about falling asleep in theatre due to long, tiring shifts. The directive is therefore seen as a step in the right direction that has saved the lives of many patients.
A valid argument was put forward that less hours would mean that young doctors would not get as much training as they would if they were working longer hours. However, it appears that a key issue has not been taken into consideration. If doctors are too tired, are they really going to benefit from the additional training? This will leave us with poorly trained, burnt out doctors who will be more likely to make mistakes. Significantly increasing the number of hours worked is not the answer to this training issue. Better management of training schedules should be the main area of concern.
While there is the option to opt out of the directive, junior doctors should not be pressured into working more hours. They should be encouraged to make good judgements on whether they are physically able to take on additional work. The EU directive is in place to protect both, the doctors and the lives of the patients they treat.