Running out of time? Perhaps not

Richards sums up the conflicting views on the European Working Time Directive.1

Monthly returns from strategic health authorities seem to be at odds with the view from the medical frontline. The Department of Health is therefore working with the royal colleges to check the returns on an individual trust basis. The results should be available well before the deadline for derogation.

Although many trusts may have 48 hour compliant rotas on paper, the practicality of these rotas is worrying. UK medical registrars usually work 4 hours more than their contracted hours.2

Parliament has shown little sympathy for health professionals’ views on the working time directive because of lack of evidence of its negative effects beyond surveys of opinion. The profession needs to provide such evidence, and quickly, to get any support for change in legislation from MPs.

However, MPs support the opt-out for UK doctors from the directive. The opt-out gives additional flexibility for service provision and training opportunities, but it should not be seen as the only solution.

Doctors may not be aware of the large amount of recurrent money the Department of Health has given trusts to support the working time directive—for example, by employing additional acute physicians. This amounts to 0.2% of tariff income, or £300 000 a year for a typical acute trust. Some trusts may have kept this funding quiet to allow the money to be used elsewhere, but it is urgently needed if the directive is not to be the disaster we fear.