In-Reply-To: <[log in to unmask]>
Thanks for those thoughts, Andrew. You couldn't be further from the mark, 
I'm sorry to say.


> > Just heard this last night - in the new review of Consultant 
> > workload, the
> > UK Government have decided that you are not at work if you are on 
> > call!
> 
> This is all about the European Working Time Directive - not a review of
> Consultant workload.
> For the purposes of this directive all workers (except transport 
> workers,
> armed forces, deep sea fisherman and doctors in training) are limited 
> to a
> maximum of 48 hours a week on average.
> For these purposes work is defined a time spent at the employers 
> disposal AND
> carrying out his duties in accordance with national laws or practice.
> 
> This definition therefore excludes time on call from home not actually
> working.
I have to challenge this. If I am at home, that in itself limits me. I 
cannot go more than 10 miles from my base hospital. I cannot (should I so 
wish) drink beyond the legal limit to drive. So: am I at work or not? I am 
at my employer's disposal, am I not? Furthermore, I am carrying out my 
duties as defined in my job contract*by the virtue of the very fact that I 
am on call*! If someone calls, I give advice or go to the hospital. It is 
analogous to a pilot who is on standby for a flight. He may be at home. He 
may not be flying an aeroplane. But he is available so to do, and this 
counts in his duty hours.

> 
> In negotiations with the NHSE it has been agreed that for all included 
> NHS
> staff time resident on call will count as work for the purposes of the 
> 48 hour
> week.

What bearing does this have on this discussion?

> 
> > So - a junior doctor is at work when on call, and has to have his time
> > fiercely protected etc, etc, but as soon as he becomes a Consultant - 
> > he
> > is not.
> 
> This is not true.
> Doctors in training are excluded from the legal provisions of the EWTD 
> but
> have the contractual protection of the New Deal which limits their 
> hours of
> ACTUAL work to 56 per week.
> The New Deal definition of actual work does not count rest while on 
> call even
> if compulsorily resident.

Again, this is not relevant as we are discussing a different body of 
doctors on different contracts.> 
> When juniors are eventually covered by he EWTD it remains to be seen 
> whether
> rest while resident on call counts as it does for Staff Grades and 
> Consultants
> or whether the New Deal definitions will be used.
> 

> 
> Fill in your diary and use it to demand the appointment of additional 
> A&E
> Consultants.

Try this one. We were shown by the Audit Commission to have too few 
doctors. They identified a review of medical manpower as the top priority 
for A&E to be fixed by March 1999. From winter pressures money a Staff 
Grade appointment was made. He had a wonderful effect on any parameter you 
care to measure. Our waiting times suddenly met the Charter Standards. 
Morale up, etc, etc.The clinical director of Surgery promised that the job 
had to be ratified after March 31st. I heard from a medical personnel 
officer in passing last week that the job would terminate on March 31st. 
No discussion, no request for analysis of benefit.

> If your Chief Executive allows working arrangements which require you 
> to work
> more that 48 hours a week he can be prosecuted by the Health and Safety
> Executive.

Governments can agree anything to make it easy for them. I see this as a 
direct way of undermining Consultants on yet another level.
> 
> He can however continue to abuse his junior staff without fear of 
> prosecution
> as we are excluded from the protection of this legislation.
Ridiculous comment. Any doctor who has not signed the English agreement 
can report the Trust to the Dean and action will be taken with 
consequences at least as bad as action under this head.

I don't want to make this an us v them situation with juniors, Andrew - we 
must all stick together. But you really need to appreciate that many 
seniors (who often baled their Consultants out in their time night after 
night on 1:2s and 1:3s) are starting to feel abused. 


Best wishes,


Rowley Cottingham

[log in to unmask]

"Tradition is slovenliness!" Gustav Mahler on taking up his position as 
Director of the Vienna House when he had been told that a change he wanted 
could not be made as,"We have always done it this way".



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