For three decades and more, junior hospital doctors (as they were once called) have been making vain efforts to get out from under the crucifying hours of work which they have been compelled to undertake. It may have been all right centuries ago to train young doctors on a laissez faire apprenticeship basis: significant and potentially dangerous technology was not available and clinical decisions were seldom urgent. But this century has brought massive changes to hospital practice, whether medical or surgical, and the old systems of training young doctors are no longer appropriate. It is certainly not safe for patients to have a young doctor trying to make critical clinical decisions in a modern hospital when she or he will have had little or no sleep in the previous 48 hours.
The non-consultant hospital doctors (as they are now called) have been trying, without success, to make this point for a very long time. They have also been trying to protect their own health and sanity in an increasingly stressful hospital environment and yet they must still toil as if they were indentured labourers with limitless work and limited opportunities for sleep and relaxation.
No Irish government has listened to them, and there has been only limited and utterly ineffective support for them among their supposed teachers - the hospital consultants. They do not even have any significant job security as they move from one term contract to another trying to learn, through experience, the knowledge and skills they require to become fully competent and independent in their chosen profession.
Not unreasonably, they had hopes that some amelioration of their conditions (and, indeed, some lessening of the risks threatening their patients with brain-dead doctors taking crucial decisions when exhausted) might emerge from this week's meeting of the Council of Ministers of the EU. That they had to wait for an EU intervention to lessen their inappropriate and dangerous load, is itself an indictment of both the senior members of their profession over the past half century and of all Irish governments over the same period. There is no good reason why Ireland could not have resolved this clear and threatening problem when other countries in the EU have long since moved individually to improve the situation for both the doctors and their at-risk patients. It is not as if the dangers had not been spelled out clearly decades ago in this country.
Why the United Kingdom and Ireland should have been so slow to come to terms with the situation can only indicate degrees of indifference and indolence in the health authorities in both these islands. And the outcome of the meeting of the Council of Ministers, whereby the non-consultant doctors will continue to be excluded for a further 13 years from the provisions of the 1993 EC agreement limiting the working week to 48 hours, will simply ensure that the indifference and indolence will continue.
The defence by the Minister for Health, Mr Cowen, of Ireland's decision to back the agreement, serves only to underline that Minister's indifference to his current portfolio (already evident from his mishandling of the looming crisis in Irish nursing). He and his predecessors have known for more than 30 years that there was a problem which needed not only to be recognised, but resolved. And they do not have to wait on EU decisions before taking the steps necessary to resolve them. The problem here can be resolved by an exercise of sovereignty, rather than passive neutrality, if the senior members of the medical profession and the Departments of Health and Finance can wake up and act. Most of them are not suffering from sleep deprivation.