European Working Time Directive
The provisions of the European Time Working Directive (EWTD, 2003/88/EC) in respect of doctors in training (NCHDs) were transposed into Irish law by the way of Statutory Instrument in July 2004 (S.I. No. 494 of 2004).
The Directive encompasses a number of measures to protect workers welfare and safety. These include:
- a maximum 48 hour working week, averaged over a reference period,
- breaks – a 20 minute break for every 4 hours and 30 minutes worked or a 30 minute break for every 6 hours worked,
- rest – 11 hours daily rest or equivalent compensatory rest and 35 hours consecutive rest every 7 days or two periods of 35 hours or one period of 59 hours of consecutive rest every 14 days.
The European Commission decided to refer Ireland to the European Court of Justice because of non-compliance with the European Working Time Directive on 20th November 2013. While Ireland has been and remains committed to achieving full compliance with the Directive by end-December 2014, the Commission was not satisfied with the rate of progress to date.
Ongoing progress has been made in relation to achieving compliance with the provisions of the Working Time Directive in respect of NCHDs. Data collected by the HSE shows that average working hours for NCHDs has fallen significantly in the past five years. In 2009 the average was 60 hours a week; this had reduced to 54 hours per week in 2012 and to 51.1 hours by the fourth quarter of 2013.
Considerable progress has also been made in relation to ensuring that NCHDs do not work more than an average of 68 hours and that they do not work shifts in excess of 24 hours, two key priorities in 2013. By September 2013, less than 3% of NCHDs were working in excess of 68 hours. The HSE and the IMO have, jointly, focused on eliminating shifts in excess of 24 hours. A verification exercise in January reported over 90% compliance with this objective; at the start of 2013 the figure was less than 50%.
Measures in train
The HSE is focused on advancing implementation of the Directive. Intensive negotiations conducted at the Labour Relations Commission in September and October resulted in agreement on a joint approach, involving hospital management, the IMO and NCHDs to achieving EWTD compliance. The agreement focused, in the first instance, on steps to be taken in the period up to the NCHD rotation on 13th January 2014 to eliminate shifts in excess of 24 hours. The agreement provides for the imposition of fines on hospitals where progress is considered unsatisfactory. While the majority of hospitals achieved satisfactory progress, arising from the HSE/IMO assessment the Director of Acute Hospitals imposed fines on a minority of hospitals where sufficient progress has not been achieved.
NCHD recruitment and retention is required in order to facilitate the achievement of EWTD compliance. Achievement of full compliance will also require reorganisation of the delivery of certain services within Hospital Groups. The number of NCHDs in the public health system has increased by over 200 in recent years and now exceeds 4,900. However, there are international shortages of NCHDs in certain categories and specialties. There are also some hospitals to which it has historically been difficult to attract applicants, in particular smaller hospitals that have onerous rosters. The planned establishment of hospital groups should help to address this issue, as this will allow doctors to be appointed as group resources – instead of to just one hospital.
The Minister for Health set up the MacCraith Group to undertake a Strategic Review of Medical Training and Career Structures last Summer. The Group is to make recommendations aimed at improving the retention of medical graduates in the public health system, planning for future service needs and achieving the maximum benefit from investment in medical education and training. The Group provided an Interim Report in December 2013 focusing on training and is now examining career structures and pathways following training with a view to preparing a report by the end of March 2014. It is to provide a final report by the end of June 2014.
Sleepovers by Staff in Residential Child Care and Disability Facilities
The issue of sleepovers by staff in residential child care and disability facilities and its impact on compliance with the European Working Time Directive was addressed in the Haddington Road Agreement and a commitment was made to completing discussions which had already taken place relating to this matter. The Labour Court has directed that these discussions should be completed no later than 31 May 2014.
Read the Proposals of the Labour Relations Commission to address maximum 24 hour shift working and achieve EWTD compliance document (MS Word).