Statement from the Department of Health and Children on the European Working Time Directive
Ireland is legally obliged to begin applying the provisions of the European Working Time Directive to doctors in training from 1st August 2004 and every effort will be made to give effect to these employment rights.
The European Commission recently initiated a review of the Working Time Directive as it applies to all workers – not just doctors in training. Changes, if agreed and supported by Member States, would require a new Directive and new Irish legislation.
A number of Member States have expressed particular difficulties in relation to the implementation of certain aspects of the Directive. These difficulties relate to two rulings by the European Court of Justice. In the “SiMAP” and “JAEGER” cases, the Court ruled on the definition of working-time, defining all time spent by a doctor on-site on-call, even if the doctor is resting, as working-time. In fact, Ireland has been in compliance with this ruling for some years.
From an Irish perspective, a more significant issue raised by the Court is in relation to the requirement to grant immediate compensatory rest to a doctor, following a period of work while on-call, and before the doctor returns to work if they have worked more than 13 hours in any 24-hour period. Ireland, along with a number of other Member States, has highlighted the difficulties this will create for rostering doctors on duty in a hospital situation, where round-the-clock medical cover is required.
Employment Ministers will be giving these matters further consideration at future meetings.
Negotiations with the Irish Medical Organisation in relation to the reduction of NCHD hours are ongoing in the Labour Relations Commission. The most recent meeting took place on 2nd March and the next meeting is scheduled for next Monday, 15th March. Management and the IMO have confirmed their commitment to substantive engagement in order to achieve the required reduction in Non-Consultant Hospital Doctors working hours. A number of further meetings have been scheduled over the coming weeks and every effort will be made to complete these negotiations at the earliest possible date.
In order to reduce NCHD hours, the following measures must be progressed:
- Reduction in the number of grades of doctor on-call at any one time;
- Introduction of cross-cover arrangements;
- Introduction of centralised rostering and shiftwork;
- Changes in skill-mix and practice for other grades of hospital staff.
It has been acknowledged that we need to establish a working group in each hospital to implement these measures and to monitor progress in relation to the reduction in NCHD hours. A National Implementation Group will co-ordinate the work being undertaken at local level. These groups should include appropriate hospital managers, consultants, NCHDs, nurses and other relevant healthcare professionals.
The urgent need to establish these groups at both national and local level has been discussed with the Irish Medical Organisation at the meetings in the Labour Relations Commission. To date the agreement of the IMO has not been forthcoming to the establishment or operation of these groups. Clearly, it is imperative that the groups commence their work and it is my wish to have them operational at the earliest possible date. The Minister for Health is calling on the IMO to agree to their establishment with a view to progressing the complex issues involved and to help ensure that the working hours of NCHD’s to the required level – a situation that the IMO has been lobbying for many years to achieve.
The idea of NCHDs normal working or training day being within a 9am – 5pm period is unacceptable and will not meet the needs of the 24/7 acute hospital service. Similarly, payment of the majority of NCHD working hours at overtime rates places an undue burden (€250 million) on the Exchequer and cannot be sustained in the long term. In fact this money would be far better utilised providing 24 hour consultant cover in our hospitals.
However, substantial progress is being made in reducing working time for many NCHDs. As we go forward, all NCHDs must benefit from reduced working hours.
In recent weeks, CEOs of Health Boards, Hospital Managers, together with senior officials from the Department and the Health Service Employers Agency met to discuss developments to date and to agree further steps at national and local level which are required to implement the Directive by 1st August. A National Coordinator and support team have been seconded to oversee the implementation process in the health agencies. Medical Manpower Managers, who were appointed under the 2000 NCHD Agreement, are also playing a central role.
One example of these preparations is the work-up of draft indicative rosters in relation to a representative group of hospitals, based on detailed information which has been collated.
We do not underestimate the very significant task facing the Government and the health agencies in ensuring that NCHD working hours are reduced as required. It is acknowledged that achieving full compliance may be very difficult within the time available. However, the existence of such difficulties in no way alleviates our legal obligations and only serves to emphasise the urgency of making rapid progress on implementation.
Every effort is being made to achieve the optimum compliance with the requirements of the European Working Time Directive, as they relate to doctors in training.
Notwithstanding these requirements, the Minister for Health and Children is determined to continue with further reductions in NCHD working hours. Excessive working hours are unsafe for both the doctor and any patients concerned. All interested parties must now cooperate to achieve a healthier and safer working environment and equally important, the safer provision of services to patients.