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Dáil Éireann debate -
Wednesday, 5 Apr 2000

Vol. 517 No. 4

Priority Questions. - Junior Doctors' Working Conditions.

Liz McManus

Question:

51 Ms McManus asked the Minister for Health and Children the steps, if any, he is taking to avert the threatened strike by junior hospital doctors over working hours and conditions; and if he will make a statement on the matter. [9895/00]

Officials of the Health Service Employers Agency and officers of my Department have been in discussions with the Irish Medical Organisation for several months on a wide range of issues affecting the working conditions of non-consultant hospital doctors (NCHDs).

Considerable progress has been made on many issues, including the resolution of disputes at indi- vidual hospital level. Some of the issues which affect NCHDs' working conditions cannot be resolved immediately. Among these are the twin issues of working hours and the restructuring of the medical career hierarchy. The working hours of NCHDs have been the subject of negotiations at European level in the context of the proposed extension of the 1993 EU Directive on Working Time to doctors in training. Deputies will be aware that different stances on this issue had been taken by the Council of Ministers and the European Parliament. I am glad to inform the House that agreement was reached on Monday on a formula which provides for a nine year transition period to apply the Directive to junior doctors. Ireland has always stated that it will reduce junior doctors' working hours to an average of 48 per week at least as quickly as required by any European legislation. I am confident that, with the full co-operation of the profession, we can achieve that objective in the nine years allowed.

As part of our preparations for this eventuality we are conducting a major study of NCHD working hours on a joint basis with the IMO. The study is being undertaken at eight hospitals by PA Management Consultants. The report of the study will be available in June. Any increase in the number of doctors required to implement the Directive on Working Time will have to be considered in the light of the report of the Forum on Medical Manpower. We do not wish to worsen the existing unsatisfactory career structure for doctors by employing more NCHDs without long-term career prospects.

I hope that continuing contacts between the two sides can avert any prospect of industrial action which would not be in the interests of patients and will not help in a resolution of the structural problems which affect Irish hospital medicine.

Is the Minister fully aware of the seriousness of the issue? The NCHDs are about to commence balloting on issues that are not directly related to the decision of the EU conciliation committee yesterday. What we are talking about, and what most aggrieves and concerns junior hospital doctors, are issues relating to previous contracts going back to 1997 in terms of the excessive hours that are driving some NCHDs beyond human endurance and putting patients at risk and also payment for overtime. I am sure the Minister is aware that, per hour, NCHDs were earning less than the minimum wage. Will the Minister deal with the current problems? If he does not do so they will lead to a most destructive industrial action in hospital services which is the last thing we need having just had a nurses' strike. Will he give a clear commitment now, in terms of the nine year time frame that has been agreed by the conciliation committee which allows for an extension in certain circumstances, that Ireland will not, under any circumstances, seek to extend the time beyond nine years?

The Deputy's question mirrors my reply in terms of the two aspects she has identified, working hours and overtime. There are many wide-ranging issues and they are all under discussion between the Health Service Employment Agency, the IMO and the representatives of the NCHDs. I am well aware of the concern among NCHDs about difficulties they have had with their employers in terms of the 65 hour limit. We recently wrote to all health boards and hospital employers asking them to adhere to the existing agreements arrived at through normal industrial relations machinery. I have some sympathy with the position of NCHDs, and I am anxious to reach a resolution of all outstanding issues involving the application of the extension of the EU Directive on Working Time. I am in the process of issuing a statement committing the Government to achieving the reduction to 48 hours within the nine year framework. We do not intend to seek a derogation from that timeframe. It is a challenging timeframe which involves a commitment not just from the Government but also from the profession and other parties involved to ensure we achieve this essential change within that timeframe. Overtime issues, pay and the issues of training, education and career paths are essential if there is to be a proper future for non-consultant hospital doctors and if we are to prevent the brain drain which has been a feature of the system for many years.

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