NHS: Seven-day Working

Viscount Bridgeman Excerpts

Thursday 6th February 2014 Lords Chamber

[Viscount Bridgeman (Con)]

My Lords, the whole House will be grateful to my noble friend Lord Ribeiro for securing this debate. He produced devastating statistics from Sir Bruce Keogh and NHS London but this debate surely cannot be complete without revisiting the working time directive. I have one or two further telling facts from my noble friend’s own royal college. For example, 86% of surgical trainees working to a working time directive-compliant rota have seen their work-life balance deteriorate. A survey published by Pulse of 500 junior doctors on the impact of the working time directive reported that 65% of respondents felt that it is having a detrimental effect on their training and 75% felt that there is now insufficient cover on the wards.

Further analysis by the royal college says that the number of hours available to surgical trainees for training and experience in compliance with the working time directive has been significantly reduced. Every month, 280,000 surgical training hours are lost to that directive and the doctors beginning their surgical training today will have 3,000 fewer hours to learn throughout their training, which is the equivalent of 128 whole days. This is but a snapshot of the telling statistics showing the handicap which the working time directive is imposing not only on patients today but on the precious investment in young medical talent for the future.

My message to my noble friend the Minister is to ask what pressure can be brought on the Commission to improve the working of the directive, which, let us not forget, has at its core wholly admirable aims. The Commission does listen. The United Kingdom, led by the Department of Health, has over the past two years taken the lead in inducing the Commission to modify the free movement directive which has hitherto prohibited the regulatory bodies in healthcare, such as the GMC and the Nursing and Midwifery Council, from testing health workers from the EEA for English-language competence before registration, potentially releasing healthcare workers on to the market with less than adequate English. That is a disaster for patient safety waiting to happen. The Commission has now listened and taken measures to modify the directive to ensure that language competency is established before a certificate of fitness to practise can be issued.

I use that as an example where the issue was patient safety. Let us be in no doubt that in the case we are debating it is simply that again, whether it is in the inadequate training of doctors to which I referred or the lack of continuity which was provided under the old structure of the firm, whose demise was one of the principal casualties of the directive. The introduction of the shift system also plays against continuity. Can my noble friend give an assurance that his department will build on his earlier successes with the Commission and give a high priority to securing a modification to the working time directive?

I finish with an instance which I assure your Lordships is not simply hearsay. I know of doctors who need to get work experience in another country within the European Union. Both the time and money available are limited and, to get the best value out of their secondments, they have quite simply chosen to go to member states where the working time directive is openly disregarded. By the way, these are not newer accession states but old, western members of the Union with highly sophisticated health services. This country has a history of abiding by the law and I leave my noble friend the Minister, and all your Lordships, to draw their own conclusions.