Doctors’ action over long working hours


Sir, – The State’s decade-long failure to implement the European Working Time Directive of 2003 is inexcusable. However, laying the totality of blame on the HSE does not explain how junior doctors have been equally slow to demand action. Most European countries implemented the law some time ago and legal challenges to authorities failing to comply have been universally successful. Though most have been resentful of unsafe working hours for years, the current movement only started in late 2012. So why are we only demanding safe practice now? Why did so few speak out for so long?

One reason of many is that junior doctors were afraid to. Some consultants remain openly critical of change and reluctant to concede that the volume or nature of today’s overnight work is different to that of previous generations. Questioning senior opinion is still feared and often considered foolish or a sign of weakness. Though variable by specialty and institution, intimidation remains common. Over 10 years, cries for help to the IMO usually resulted in hushed, sympathetic inertia rather than vocal public support. This is unique among health professions. A sense of abandonment might explain why less than half of junior doctors were even members until the recent groundswell of vocal opinion finally forced senior IMO members’ hands to action.

From politics to the priesthood and from banking to the bar, the question recurs as to why we Irish consistently fail to speak out. Cultures of silence persist. Though we recognised our rosters as unsafe, most of us focused primarily on getting through the work. Good doctors struggled and patients suffered preventable clinical errors. I, for one, did not speak up enough for them.

2013’s junior doctors deserve great praise for speaking out. I just hope that their collective example serves not only as a means to an end, but also to foster a new cultural beginning. – Yours, etc,


MRCPI, Specialist Registrar

in Cardiology, Fulbright

Scholar at Dept of Health

Policy, Harvard University,


Massachusetts, US.