DOCTORS: THESE 80-HOUR WEEKS CAN’T CONTINUE
Hospital medics fear fatigue-related mistakes as they highlight their 24-hour shifts and claim they’re treated with contempt by the HSE
JUNIOR doctors fear that fatigue could lead to fatal mistakes on the job as they work shifts longer than 24 hours and in some cases more than 80 hours a week.
Young medics say they are being treated with ‘contempt’ by the HSE and are seeking a wage rise to combat the rising cost of living, as well as safe working conditions where the lives of their patients are not potentially put at risk.
A ballot over industrial action is set to go ahead next week, and if it leads to a strike, it would cripple patient care as the 7,500 junior doctors in the country account for two-thirds of the medical workforce.
Dr Eoin Murphy, a GP registrar, said rules limiting the hours non-consultant hospital doctors (NCHDs), or junior doctors, can work were being ‘flagrantly, routinely, and ubiquitously breached in every hospital’. He told the Irish Daily Mail that he worked on hospital wards and in the emergency department until eight months ago. ‘I vividly remember the
strain of doing two to three 24hour shifts a week covering very, very busy wards. It’s a part of the career that no doctor forgets lightly,’ Dr Murphy said.
‘There are anecdotal cases, up and down the country in hospitals, where there are people coming in on the Saturday and going home on the Monday morning.’
The Irish Medical Organisation (IMO) is balloting NCHD members to seek approval for industrial action, up to and including strike action next Monday, May 9, ‘in the event that the HSE does not engage meaningfully to resolve the situation and implement much-needed reform’.
The IMO has said the strike is a last resort, and that many issues could be addressed quickly, such as paying doctors for every hour they work, and allowing them to leave the hospital at the end of their roster.
Junior doctors worked 2.8million overtime hours last year, over 100,000 more than in 2020 and a year-on-year increase from 2012, according to figures released by the HSE.
Many have reported burnout, mental ill-health, emigration, inability to take annual and educational leave, not being paid for hours worked, and delaying having children for fear of impact on training opportunities.
However, the central concern is illegal and unsafe working hours.
Following industrial action by doctors in 2013 under the banner 24 No More, hospitals had to commit to not exceeding 24-hour contracts as part of the EU Working Time Directive (EWTD).
The agreement also stated that no trainee hospital doctor should
‘Contempt we are treated with’
work more than 48 hours a week.
But, Dr Murphy said, the EWTD has been routinely breached.
He said part of a safer work environment would involve spaces for doctors to rest in every hospital.
‘On-site rest rooms, good accommodation, warm accommodation with heating. You know, parking fees, things that make you feel like you’re welcome and really accommodated in the place that you’re working, not a pawn that can be moved around,’ he said.
The IMO reported in April that 96% of the NCHDs it surveyed had been required to work over 48 hours a week, with 40% working over 24 hours in one shift.
Dr Murphy is on the NCHD committee of the IMO, which is balloting its members for strike action on Monday next.
He said that doctors do not consider strike action lightly and the IMO is ‘very happy to negotiate’, but that there is ‘pure intransigence on the part of the HSE’.
‘The fact that the HSE was able to come out recently and say that in the last year NCHDs worked 2.8million overtime hours is just shocking and shows the contempt that they treat us with, and that is why we have taken the ultimate decision to consider industrial action,’ he said.
He asked the public: ‘Would you rather have a doctor that’s treating you on their sixth hour or their 16th hour? We are only as good as the system that we work in.’
The IMO also found that 96.8% of NCHDs it surveyed reported experiencing anxiety, exhaustion and stress, with the vast majority saying they lacked a good worklife balance.
Dr Murphy said colleagues he has spoken to would rather take a pay cut and work more reasonable hours than carry on working as long shifts as they are.
HSE data released recently showed that NCHDs were paid €118.84million overall for overtime last year, with the four highestpaid receiving overtime pay in excess of €150,000 in 2021 on top of their basic salaries.
Dr Murphy said: ‘The hours that you have to work to earn that as a junior doctor are absolutely gutwrenching. There is no chance to have any sort of social life or any time for a healthy lifestyle.’
Consultant haemotologist Dr Gerard Crotty said that the overtime pay figures show that doctors are ‘working illegal hours’ and ‘are having an awful time’.
He said he has been campaigning for better hours and working conditions for junior doctors since he was an intern in the 1980s.
He added: ‘I think the vote will be overwhelmingly in favour of industrial action... No doubt tough negotiations will follow.’ Dr Crotty added that while he hopes it won’t come to a strike, ‘I would not have confidence in Department of Health/HSE doing the needful given past performance’.
The chair of the IMO NCHD committee, Dr John Cannon, has said NCHDs across the country are ‘demoralised, frustrated and angry’. He said: ‘All junior doctors live in fear that they are going to be so exhausted and so tired that they are going to make a serious fatigue-related mistake.
‘None of us want to be working 24 hours, none of us want to be working 80 hours a week. I think if you fix that core issue, then a lot of the other things will not be as acute – they won’t disappear completely, but it will relieve some of the pressure.’
A spokesperson for Health Minister Stephen Donnelly said: ‘The minister met with NCHDs recently with regard to a number of concerns they had raised. This group perform a very significant role in our public health system, not least through the last two years. The department are following up on the issues raised by the NCHDs at present and will be engaging further in the coming weeks.’
‘Junior doctors live in fear’