EU Working Time Directive (NHS)

Ian Paisley Excerpts

Thursday 26th April 2012 Westminster Hall

[Ian Paisley (North Antrim) (DUP)]

Thank you, Mr Brady, for giving me the opportunity to speak unexpectedly early in the debate; I really appreciate it. The European working time directive is a complete disaster. Those are the words not of some amateur politician, someone on the street, a journalist or a headline maker, but of the president of the Royal College of Physicians, Sir Richard Thompson. He has described the European working time directive as “a complete disaster” for both patient care and the quality of training. He said:

“We are not providing the service or the training that we require. I cannot overemphasise the damage to service provision and to training.”

The directive is a complete disaster in terms of providing a service to the people who need it the most—the vulnerable and the sick. It is a complete disaster to the physicians who are the lifeblood of the NHS; and a complete disaster to the future of our hospital structure.

In September 2010, the European working time directive impacted on hospital rotas. The Royal College of Physicians criticised “the reliance on locums” in rural hospitals in particular. It said that

“a service opt-out or modification should continue to be pressed for.”

The Causeway hospital in my constituency faces losing its accident and emergency department, which is the only such facility in one of the most rural parts of Northern Ireland. The area has one of the largest inflows of tourists at certain times of the year. Why is the department going to close? It is going to close not because it is useless or there is no demand, but because of its over-reliance on locums, which is a direct result of the European working time directive. It is a complete disaster for our rural hospitals. It is a complete disaster in terms of sickness leave among doctors. The report of the Royal College of Physicians, which was published in April 2010, shows that sickness leave has soared since the European working time directive was introduced. It says:

“The apparent rise in sickness rates of junior doctors since the introduction of the European Working Time Directive highlights the additional stresses that are being put upon trainees by new rotas.”

Let us not mince our words: this is a complete disaster. Let us be honest and say it as it is. As far as the NHS is concerned, the European working time directive has failed and we need to get a better plan or structure in place that coincides with the needs of patients and with the ability of our physicians to deliver the best care service in the world. The sooner that we call this as it is the better.

[Mr Nuttall]

The hon. Gentleman is making a powerful case. Does he agree that the effects of the working time directive on our respective constituents is one reason why an increasing number of people are reaching the conclusion that we would be better off out of the European Union?

[Ian Paisley]

The hon. Gentleman pre-empts me. He is a mind reader. He seems to be able to find something that perhaps we are all agreed on. If the directive is a complete disaster; if it is starving our patients of good care and our junior doctors and senior physicians of being able to deliver what they are brilliant at delivering, we should address the problem at its root. The root cause is that we have a poison in the body politic of this kingdom. We are being regulated by people who do not live in this kingdom, do not care about this kingdom, are not part of this kingdom or do not have the needs of this kingdom at their heart, and we should stand up and recognise that. The over-regulatory practice that is being put upon us by Brussels is destroying this country. The sooner that we realise that, the better, and the sooner that the Government realise that and recognise that they should address the root cause of the problem, the better for us all.

[Chris Heaton-Harris]

The hon. Gentleman should just come off the fence. I have to declare that I was a member of the European Parliament for 10 years and served alongside his father. On two occasions, I attended an employment committee meeting in Brussels and saw Labour Ministers pleading with representatives to not allow the various connotations of the directive to flow through. Back in 2004, when the Commission opened up its first rethinking of this process, Labour Ministers came to the Parliament to plead with their MEPs not to vote to insist that this went ahead and to plead with the rest of the Parliament to allow Britain to do the right thing for its own people.

[Ian Paisley]

The hon. Gentleman gives us a valuable insight, or an inside track, into what the horse trading is really like in Brussels. This is not about the needs of the constituency or of the people, but about horse trading. It is about what we can achieve here to solve something in Brussels, Lithuania or Greece that is completely unrelated to the health needs of this nation. That horse-trading mentality is failing this nation. The insight that the hon. Gentleman provides is useful, and I am glad that he has come out from the shadows of Europe and, like me, is standing here in this Parliament. I know the happy times that he spent with my father when he was in Europe.

Other nations do not gild the lily as we do. We are pretty special at gilding the lily. We can really implement regulations like no one else. Why do the Government do it? Every other European nation seems to interpret the European working time directive in whatever way they want and get away with it. I am amazed that Ireland—the other bit—has been able to interpret the directive its way and get away with it. Surely, if it can say that training is not part of being a doctor, we too can find the flexibility—a word used by the hon. Member for Bristol North West (Charlotte Leslie)—necessary to make this work for us. Let us use the F-word; let us be flexible and get this right for our patients, our hospitals and our services.

In Lithuania, there is poor EWTD compliance because of the recession, so it can get away with it. Greece, too, has got away with not implementing the European working time directive because of its poor economic financial state. Surely, we can get away with implementing the European directive our way, and in a way that is flexible for our people and for our country. Apparently, Portugal is fully EWTD-compliant. However, many doctors and surgeons there now work more than their contracts say that they should. Surely, if the rest of Europe can find a way to be flexible to suit the needs of their people, it is not beyond the kith of men or beyond our wonderful Health Minister who is here today and our wonderful Department of Health to come up with a way to make the directive flexible for our people, for our nation, for our kingdom and—most importantly—for the needs of our patients, and to allow our doctors to deliver the service that they need to deliver?

I believe that we have a complete erosion of fundamental realities when we look at how the EWTD is being implemented to the destruction of the delivery of service and patient care. I hope that the Minister and the Department are listening to a voice that is coming across from all this kingdom, which says that the directive needs to be changed and changed fast.

--- Later in debate ---

[Chris Skidmore]

Sixty hours would be a start—65 is what most people seem to be calling for. It is about getting a balance. We do not want to go back to the 80, 90 or 100-hour working week, but nor do we want to face the consequences of the 48 or 56-hour working week. There is a balance to be struck, and I would be very interested to hear what the Minister thinks can be done. This debate is obviously an interesting one because it can go down a European direction, which I know a Health Minister cannot say very much about today. However I would be interested to hear what he has to say about the NHS in his capacity as a Health Minister.

[Ian Paisley]

There is also the issue of bean counting. We must be very careful, because this debate is about delivering something to the patient and ensuring that the team around the patient, including the doctors, co-ordinate their work to meet the needs of the patient. If we get into very strict bean counting—whether we are talking about 48 hours, 60 hours or whatever—and do not recognise that this is about a patient-centred service, we will keep having more and more of these problems that we have discussed. That is the critical issue, and why we need the flexibility.

[Chris Skidmore]

I entirely agree with the hon. Gentleman. Patient-led care is where we must get to. That is why we are all here; that is what the Health and Social Care Act 2012 will deliver. I am sure that we will all be working further to ensure that the patient is placed at the heart of the NHS.