The provisions of the European Working Time Directive (EWTD) encompass a number of measures to protect workers' welfare and safety, including a maximum 48 hour working week - averaged over a reference period, daily and weekly rest periods and the granting of compensatory rest where the working day exceeds 13 hours. Under the Directive, the 48 hour average working week became a requirement for NCHDs with effect from 1 August 2009. The Directive has been fully transposed into Irish law.
I have emphasised to the HSE the importance of achieving EWTD compliance as soon as possible. The HSE has been working intensively to advance implementation of the Directive in respect of NCHDs and considerable progress has been made over the last 12 months. HSE data shows that average working hours for NCHDs in 2009 was 60 hours a week, 54 hours per week in 2012 and 51.4 hours in the second half of 2013.
Intensive negotiations conducted at the Labour Relations Commission in September and October resulted in agreement on a joint approach, involving hospital management, the IMO and NCHDs to achieve EWTD compliance. The agreement focused in particular on steps to be taken in the period up to the NCHD rotation on 13 January 2014 to eliminate shifts in excess of 24 hours. In January and February this year progress made by acute hospitals on achieving compliance with the agreed maximum 24 hour shift target was assessed. That assessment showed that the majority of hospitals had made significant progress with over 90% compliance. Fines were imposed on 10 hospitals in March where progress was deemed unsatisfactory.
NCHD recruitment and retention is required in order to facilitate the achievement of EWTD compliance. Achievement of full compliance will also require reorganisation of the delivery of certain services within Hospital Groups. The number of NCHDs in the public health system has increased by over 200 in recent years and now exceeds 4,900. However, there are international shortages of NCHDs in certain categories and specialties. There are also some hospitals to which it has been difficult to attract NCHDS, for a range of reasons including training opportunities and rural location. Where feasible consultant recruitment is being pursued as an alternative to the use of NCHDs.
I set up the MacCraith Group to undertake a Strategic Review of Medical Training and Career structure last summer. Its work will support the attainment of EWTD compliance. The Group is to make recommendations aimed at improving the retention of medical graduates in the public health system, planning for future service needs and achieving the maximum benefit from investment in medical education and training. It provided an Interim Report in December 2013 focusing on training and last month provided a further report covering career structures and pathways following training. The Group is to provide a final report, encompassing workforce planning, by the end of June 2014.