Doctors’ hours cut sees NHS waiting lists rise.
After years of decline, NHS waiting lists have begun to rise again since the introduction of European rules on junior doctors’ working hours.
Since the 1990s waiting times in the NHS had been dropping, but in August 2009 new legislation was introduced limiting junior doctors to a maximum of a 48-hour week. This has resulted in reversing the trend and seeing thousands of more patients now waiting longer than 18 weeks for surgery.
With this introduction, Ministers are seeking to renegotiate Britain’s position on the European Working Directive, including a possible opt-out for NHS staff. Since the introduction of the new legislation, The Royal College of Surgeons have carried out the first comprehensive analysis to see how this directive has affected waiting times.
The research has highlighted that the proportion of NHS patients having to wait longer than the target of 18 weeks for non-emergency surgery such as a hip replacement had almost doubled from 1.5 per cent 18 months ago to nearly 3 per cent in March of this year. By the end of 2008, patients waiting times reached an all-time low with the average waiting time being just a few weeks.
However, since the EU directive cut junior doctors’ hours from 56 to 48 per week, these gains had been wiped out, the Royal College said.
According to figures fro the Department of Health, the number of patients waiting longer than 18 weeks from GP referral to being treated as an impatient fell steadily from April 2007, when almost 34,000 people were waiting, to 8,674 in December 2008. This figure remained stable at around 10,000 until June 2009, just before the new rules came in, when the figures began to rise again. By March of this year, the numbers waiting to be seen had risen to 17,515, a level last seen in September 2007.
John Black, the President of the Royal College of Surgeons, said, “The increase was predictable. If you have the same number of patients, no more doctors and ask them to work less then it is inevitable that the time available for elective procedures will reduce and waiting lists grow. Most European countries had bypassed the legislation by either not monitoring compliance or, as in Germany and Holland, finding ways around the directive. We look forward to this happening in the UK.”
Now almost 66 per cent of consultants frequently operated without assistants because departments were so stretched.
Sir Richard Thompson, the new President of the Royal College of Physicians said, “The directive had been a complete disaster for both patient care and the quality of training for doctors. We are not providing the service or the training that we require. I cannot over emphasise the damage to service provision and to training.”
Dr Matt Jameson-Evans, a spokesman for Remedy UK, a junior doctors campaign group said, “The impact of the directive on services was inevitable. Patients are simply not being treated by as many doctors as before. A second consequence of this and equally important is that doctors are not receiving as much training as they were and this has serious implications for the future quality of care.”
In response to the directive, the Royal College of Surgeons has argued for an opt-out. The opt-out will allow trainees to work up to 65 hours per week because under the current 48-hour week, trainees are just not getting enough practical experience.
The previous 18-week target has now been abolished by the coalition saying it was not backed by evidence that it benefited patients.
Dr Mark Porter, the chairman of the British Medical Association’s consultants committee, said, “The drive for cuts within the NHS was also a factor in the rise in waiting times.”
A spokesman from the Department of Health said, “We want patients to receive treatment, not when an arbitrary target dictates, but when it is most clinically appropriate for them to be seen. On the European Working Times Directive, the Health Secretary will support the Business Secretary in future negotiations on its revisions, including maintenance of the opt-out.”
With the numbers of hours per week doctors are allowed to work, as well as government cutbacks, more NHS trusts will need to seek alternative solutions to reduce waiting lists. With the changing demands for doctors and GP locums, MPP Locums is well placed to meet these changes.
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