Working Time Directive

Oral Answers to Questions — Health – in the House of Commons at 2:30 pm on 23 June 2009.

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Photo of James Brokenshire James Brokenshire Shadow Minister (Home Affairs) 2:30, 23 June 2009

What his most recent assessment is of the effects of the European working time directive on acute hospital services in the future.

Photo of Andy Burnham Andy Burnham The Secretary of State for Health

Our aim is to ensure that, consistent with patient safety, the maximum number of services are supported to achieve compliance with the directive by 1 August. Two hundred and forty-seven trusts have now reported on 6,646 rotas. Following independent scrutiny, the proposed number of services for derogation is 200. I will shortly lay a statutory instrument before Parliament which will amend the working time regulations and set out the relevant information in detail.

Photo of James Brokenshire James Brokenshire Shadow Minister (Home Affairs)

What action will the Secretary of State take to deal with the significant concerns about the impact of the working time directive? Also, given the picture that he has painted of the action that he has taken, why has the British Medical Association suggested that there is insufficient preparation in some hospitals to deal with the fall in doctors' working hours and that the funds needed for that are simply not getting to the front line?

Photo of Andy Burnham Andy Burnham The Secretary of State for Health

We have taken great care to ensure that patient care is not disrupted by the implementation of the directive. That is precisely why the statutory instrument will set out those services which will need more time to prepare for the full adoption of the working time directive. However, the hon. Gentleman has to accept that the issue is fundamentally about patient care. Tired doctors make more mistakes—all the evidence points to that—and I do not think that we want to return to the past, when junior doctors worked up to 70 or 80 hours a week and made more mistakes than they might otherwise have made.

Photo of David Taylor David Taylor Labour, North West Leicestershire

The figures suggest that in March 78 per cent. of NHS trusts were compliant with the European working time directive, but that that fell to 64 per cent. in April. Will the Secretary of State tell us what he expects the figure to be for May, which is due to be released soon, and are we really prepared for the significant reduction that we shall see from 1 August?

Photo of Andy Burnham Andy Burnham The Secretary of State for Health

It is important to say that two thirds of junior doctors in the health service are now working to compliant rotas, and that all other NHS clinical and staff groups are already compliant with the directive. That means that a substantial part of the staff in the NHS are already compliant with the requirements of the directive. Of course we continue to keep a close watch on these matters, and we will take every possible step to ensure that there is no disruption to patient care after 1 August. The statutory instrument that I am bringing forward will provide extra flexibility for NHS management to ensure that the measures are introduced safely.

Photo of Richard Taylor Richard Taylor Independent, Wyre Forest

Two of the serious casualties of the shift system are continuity of care for patients and continuity of learning for junior doctors. How can these matters be specifically addressed within the 48-hour week?

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How sincere is the BMA in supporting your two concerns? Their primary interest often appears to be do with money rather than...

Submitted by Rod Storring Continue reading

Photo of Andy Burnham Andy Burnham The Secretary of State for Health

The hon. Gentleman raises an important point. He will know that my predecessor asked NHS Medical Education England to look again at junior doctors' training, to ensure that, as part of their new working environment, they would get a grounding in all the necessary subjects. A review is under way into junior doctors' training, and I hope that I can give the hon. Gentleman an assurance today that it will pick up precisely the point that he has raised.

Photo of Rob Marris Rob Marris Labour, Wolverhampton South West

Since the Government do not believe that statutorily limiting an employee's average working week to 48 hours helps a worker's health, what hourly limit, if any, do they believe to be appropriate?

Photo of Andy Burnham Andy Burnham The Secretary of State for Health

Obviously, individuals retain the ability to opt out of the requirements of the directive, but as I said earlier, this issue is fundamentally about patient safety. It is also about helping individuals to balance their work and home lives, and about ensuring that, when they are at work, they perform to the very best of their ability. We believe that we can safely introduce the working time directive across the NHS and that, overall, the outcome will be staff working to the highest of their potential while ensuring that patient safety is the absolute priority for the NHS.

Photo of Norman Lamb Norman Lamb Shadow Secretary of State for Health, Liberal Democrat Spokesperson (Health)

If I am not allowed to welcome you to your Chair, Mr. Speaker, may I at least welcome the Secretary of State back to the Department of Health, and the two Ministers to their posts?

The Secretary of State will be aware that one of the key findings of the Healthcare Commission in regard to Staffordshire hospital was the concern about low staff surgical rotas. The president of the Royal College of Surgeons has warned of the potentially "catastrophic" impact on hospitals of the new rules, saying that patients could be put at risk and that some could die. He also said that training could suffer, and that there was a risk of hospitals closing for emergencies. Given that we are now six weeks away from the implementation of the rules, will the Secretary of State agree to initiate a full risk assessment of their impact on patients, and to act in accordance with its findings?

Photo of Andy Burnham Andy Burnham The Secretary of State for Health

I hope that when the hon. Gentleman sees the statutory instrument he will be reassured that it will provide the necessary flexibility in the specialties that it lists to ensure that the requirements can be safely introduced. I would also point him towards the evidence that early adopters of the directive, such as Homerton hospital, have shown a reduction in adverse incidents on the wards. Also, research by Warwick university medical school on trainees working in Coventry and Warwickshire university hospitals compared the number of errors made by junior doctors working no more than 48 hours with the number made by those working no more than 56 hours a week. It showed that fewer clinical errors were made by those working fewer hours. There is therefore good evidence to show that this move will improve patient safety in the national health service, although we of course take seriously the concerns that the hon. Gentleman has raised, and we will proceed cautiously at all times.

Photo of Stephen O'Brien Stephen O'Brien Shadow Minister (Health)

May I from the Opposition Benches welcome the Secretary of State to his new post and to his first questions?

Mr. Speaker, as you will know, and as I discovered through a recent freedom of information request, Buckinghamshire hospitals need to lose 1,360 hours of doctors' training time to meet the requirements of the European working time directive. Will the Secretary of State confirm that patients will face cuts in care and that doctors will face worrying cuts in training because his Labour MEPs failed to oppose this European imposition?

Photo of Andy Burnham Andy Burnham The Secretary of State for Health

I do not wish, at your first parliamentary questions, Mr. Speaker, to inject a note of political discord, but let us get some facts on the record. The last NHS work force census recorded that 34,910 consultants were working in the NHS—a 56 per cent. increase on 1998. It also showed that the overall number of doctors in training is 49,178—a 60 per cent. increase on 10 years ago. This Government have invested in putting more staff on the wards and they have not run junior doctors into the ground so that they were unable to do a proper job of caring for this country's patients.