My Lords, much has already been said by our legal Peers and others on the legalities and technical aspects of this Bill, so I shall focus on just two areas this evening. One is the European working time directive and the other is the Euratom treaty. The European working time directive was introduced to ensure that workers such as truck drivers did not work excessively and fall asleep at the wheel, causing accidents. Introduced in 2004 for doctors in training, it coincided with my period as president of the Royal College of Surgeons, from 2005 to 2008. We published several publications, and there were publications from the speciality associations for trainees in surgery. They noted the negative effects of the directive on the quality and continuity of care given to patients, and on the quality of the training provided for our junior doctors. The impact of the European working time directive on medical graduates in 2002 was surveyed in 2013 and 2014 and reported in the journal of the Royal Society of Medicine. More than 3,000 doctors were surveyed and 64% responded, which is quite high. More than two-thirds of doctors believe that the directive has had a negative effect on the continuity of care and on junior doctors’ training—no change from the surveys that we carried out during my presidency. The majority disagreed that it benefited the NHS but noticed an improvement in doctors’ work-life balance. Surgeons, unsurprisingly, were the least positive about the directive. This was also true for the other craft specialties.
Ten years on and little has changed. Even Norway, to which we often liken ourselves in Brexit terms, adheres to the 48-hour working week but has experienced problems with surgery and believes that a degree of flexibility is required for that speciality. The change from being on call while residents in a hospital to shift-working has not reduced fatigue or made for happier doctors. Even the BMA, a champion of the European working time directive, accepts that fatigue is still a problem. Add to this the loss of the firm structure, with three junior doctors working together in a team providing moral support to each other, whereas we now have one doctor working in isolation, often for 13 hours at a stretch at night, for four nights in a row with very little in the way of support and nowhere to lie down or have a kip because he is there to work. That is what is happening. We have moved from an on-call situation, where people could rest and then carry on working, to one where they are expected to work all the time. It is hardly surprising that it has had an effect on junior doctor morale. My plea to the Minister is that we do not adopt the EWTD in its present form but seek to ensure flexibility for those who practise craft specialties, who have to acquire not only knowledge but demonstrate the ability to carry out surgical and other operative procedures.
What are the implications of the UK leaving the Euratom treaty? The EU Home Affairs Committee on which I sit took evidence from medical specialists on the risks of leaving Euratom. I am mindful that 80% of the radioisotopes we use for diagnostic and treatment purposes are imported from outside the UK, the majority from the EU, but also from Australia, South Africa and the United States. These materials have a half-life and decay over time. Their transportation is therefore time critical. Euratom is a major contributor to the Horizon 2020 project and the UK benefits by some £32 million for nuclear research, much of which is utilised by our universities. I have concerns for our research industry if the UK leaves Euratom. I therefore ask my noble friend the Minister: what plans do the Government have to set a timetable for replacing the provisions of the Euratom treaty with alternative arrangements? What assurances can the Government provide that our access to radioisotopes will not be compromised by our withdrawal from the EU?