EU Working Time Directive (NHS)

Rebecca Harris Excerpts

Thursday 26th April 2012 Westminster Hall

[Dr Poulter]

My hon. Friend makes a very good point and the issue that I was just raising—that of locums and out-of-hours care—ties in very well with it, because those checks and balances very much occur in the sector of locum work. To fill staff vacancies in GP rotas in primary care and in hospital rotas, doctors are often rushed in at short notice from locum firms, even though we have not necessarily got the proper checks that would be in place when doctors are working in hospitals.

As I have said, doctors from overseas make a huge and valuable contribution to the NHS, but they do so when they have been familiarised with the British medical system and they are embedded in our hospitals up and down the country. However, there is a real danger: when we have an over-reliance on locums, which is a direct consequence of the EWTD, the problems that my hon. Friend has highlighted occur, and that has damaging effects for patients.

The key issue for me in this debate is the continuity of care. The point has already been made in interventions that bad things happen to patients at weekends and out of hours, because there are fewer doctors, nurses and members of staff working in the hospital. If we have a system in place whereby doctors are clocking on and clocking off and they are encouraged to do so because hospitals are worried about the dangers of litigation and that encourages the handover of information to another professional because people think, “I’ve finished now; it’s not my job anymore,” that will encourage bad things to happen out of hours.

[Rebecca Harris (Castle Point) (Con)]

On that critical point, is my hon. Friend aware of the effect that that is having on patients and their relatives? They know that something is going on. People are saying, “How is it that highly qualified doctors did not recognise that my relative, who was chatty, friendly and bright eight hours ago, is now distant and uncommunicative?”—something as simple as that. Without years of medical training, they know something is going very wrong.

[Dr Poulter]

My hon. Friend makes a very good point. Continuity of care really matters in terms of what is good medical practice, good for relatives and good for patients. Traditionally, one team took responsibility for looking after a patient and providing holistic care to their family, particularly end-of-life care or when a patient took a turn for the worse. It is not acceptable for a doctor with no previous knowledge of that patient or their family to deal with sensitive circumstances. Indeed, it is very difficult to have any sense of good care when care is continually handed over, in a pass-the-parcel fashion, to the next person who picks up the baton after a shift is timed out—that is not good care. It is bad for patients, bad for families and particularly bad for distressing end-of-life care and the care of the elderly.

For all those reasons, we need to sort out the EU working time directive. It is bad for medicine. It is bad for doctors. It is bad for doctors’ training. It is bad for patients. I know the Minister is on our side and that the Government are working hard. I look forward to hearing the Minister’s comments, and I pay tribute again to my hon. Friend the Member for Bristol North West for securing the debate.