Sir, - With your permission, may I pass on some career advice to parents whose children are aged 10 or under? You can now encourage your children to pursue a medical career safe in the knowledge that the powers-that-be have kindly decided that, when they eventually qualify, a maximum 48-hour working week will be in operation.
Of course, one can be absolutely certain even at this stage that many of these children will work in excess of this because our hospitals and health service will not have had sufficient time to prepare. After all, the issue of excess working hours for young doctors has been on the healthcare agenda for a quarter of a century and little progress has occurred, so a further 13-year derogation is hardly likely to make a difference.
Let's be clear on the reason why Europe wants this scandalously long phase-in period: the present system provides public health systems throughout the continent with cheap medical labour. Generally the longer these doctors work, the less per hour they are paid. Why change this system, especially when senior medical colleagues collude, with their "well, I did it and it didn't do me any harm" mentality.
The profile of medical students continues to change. A majority are young women. Most, if not all, have a genuine desire to help their patients. However, unlike previous generations of doctors, they are no longer willing to devote themselves to their career to the detriment of family life. People should welcome this development as it will ultimately improve healthcare by removing the pedestal on which the profession was placed (and indeed placed itself) in the past. The adoption of sensible work practices, for young hospital doctors and, indeed, within general practice, is essential for this to occur.
One issue which is traditionally used as an excuse for these intolerable hours is the fact that speciality training requires people to be exposed to a level of illness which can only be attained by being present in hospital for all of these hours. This, of course, ignores the fact that many young doctors are not training to be specialists but are working to gain experience for a future career in general practice. They would be much better served by working less and having properly structured teaching while at work. The experience of countries such as Australia is a superb specialist health service despite (or because of?) introducing a system of shorter working hours, allied with properly paid overtime rates for its doctors.
My advice to current young doctors and medical students in Ireland is: by all means accept this directive but only on condition that, in the interim, overtime rates are introduced which mirror those of other hospital workers. I suggest that if this were to happen, the change in hospital work practices required for the reduction to a 48-hour week would be achieved considerably earlier than 2012. - Yours, etc. Dr Shane Corr,
Killiney, Co. Dublin.