Euro rules will stretch hospitals

11:31am Friday 16th April 2004

MEDICAL bosses are staying tight-lipped over how many junior doctors will be needed in the area once the European Working Time Directive comes into force.

Buckinghamshire Hospitals Trust either can't or won't say precisely how many staff are needed to work at Wycombe, Amersham and Stoke Mandeville hospitals once the directive starts in August.

Under the directive, junior doctors should work a maximum of 58 hours, including breaks, reducing to 48 hours by August 2009. Hospitals which do not comply will be breaking health and safety laws so, more doctors would be needed because at present, many work long hours to keep the system going.

The directive was preceded by a Government initiative, New Deal, to cut the hours of junior doctors. But a report a year ago showed that half of junior doctors were working above the limit and a quarter were working more than 70 hours a week. At present, 83 per cent of hospitals do not comply with the directive.

Dr Andrew Kirk, medical director of Buckinghamshire Hospitals Trust, said: "Doctors are human they get tired. The pressure of the work means that working set hours with set breaks are important. We don't want mistakes because of overtiredness."

The directive is one of the key factors behind changes to local health services outlined in the document Shaping Health Services.

Junior doctors, who have already studied for six years to qualify, work in hospital departments as Senior House Officers and later as Registrars, training for about 12 years to become consultants.

Last month, in the House of Lords, it was estimated that between 7,000 and 10,000 would be needed to met the directive.

Dr Kirk said that 440 more children's doctors at registrar level would be needed nationally and training doctors takes a long time.

"We would need more people to meet the working time directive or we have to do things in a different way," he said.

That is what Shaping Health Services is about.

One answer is to reconfigure hospital services, creating new specialist centres at one or other of the hospitals, or, in the case of mothers and children, merging services at one hospital. This could enable the hospitals to provide 24-hour care without having to find extra doctors.

Dr Kirk said the hospitals had been working on sharing services for about five years, aiming to improve the quality and range of services. It had already happened with urology centred at Wycombe and ophthalmology based at Stoke - and had caused no problems.

In the future, new cardiology, haematology and rheumatology centres could be set up at Wycombe.

Another change is to encourage doctors to cover for each other and nurse practitioners to take on some of the doctors' work at night.

A third proposed change is to move some hospital work into GPs' surgeries.