Madam, - May we respond to the recent articles in The Irish Times and Dáil reports on issues regarding Non-Consultant Hospital Doctors and the difficulty that the imposition of the European Working Time Directive will imply.
May we in particular respond to reported statements from the Taoiseach, the Tánaiste, the Health Service Employers' Agency and the Minister for Health. These imply that "junior doctors" have no interest in complying with the directive as they will lose out on overtime payments.
These Government and HSEA statements unfortunately miss the point.
Concerns expressed by the RCSI, the RCPI, Irish Higher Surgical Training Group and other doctors' organisations have nothing to do with money.
Our concerns stem from experience both here and abroad, that injudicious imposition of rosters and regimented shift-working patterns could be disastrous for continuity and safety of patient care and for high-quality NCHD training and medical practice.
As surgeons in training, we can predict a fall in clinical and surgical training opportunity of 50-70 per cent.
We have clearly demonstrated these concerns to the HSEA, RCSI and IMO and our training bodies and worked strenuously to avoid this. We have achieved a degree of consensus with (committed management representatives from) the Department of Health and Children, the RCSI, the IMO.
If the proposals worked out are completely ignored and crisis ensues, where does responsibility lie? Whom does such a crisis benefit? The patients and junior doctors? Probably not, they are stressed enough already, they are the most vulnerable groups, and they have the most to lose.
Perhaps it benefits the Minister and the HSEA, who get to blame it all, as usual, on the doctors, an easy target. It's a cheap shot, and it is clear that already the media spin and PR battle is directed this way.
Fair play to them, they are the professionals in playing the media game.
Perhaps a crisis will aid the Minister in his negotiations with the Department of Finance to fund the improved health service this country deserves and has long waited for.
What are the facts, in all this spin?
1. Repeated letters to your paper point to deficiencies in service and structure in a wide variety of areas of health service responsibility.
2. It is a fact that all medical groups and interested parties, through repeated consultative proceedings and many published reports, are in broad agreement with the Department and current Minister on the reforms needed, but where is the funding?
3. It is unfortunate that long-standing industrial relations difficulties between Government and the HSEA on the one hand, and the IMO and IHCA on the other, have soured the atmosphere at such a critical time. Both sides may be attempting to use the directive to gain leverage in this industrial relations process.
But fundamentally the challenge posed by the directive is not about industrial relations, it is about maintaining continuous safe patient care and standards of training and practice.
This is what we and the Royal Colleges in Ireland are about, this is a very serious difficulty that we face. It is possible to work towards a solution and this needs to be continued in a co-operative manner, regardless of the date. - Yours etc.,
RONAN CAHILL, PATRICK J. KIELY, DYLAN MURRAY, PETER WALSHE, DIARMUID MURPHY, CARMEL MALONE, FRANK O'BRIEN, BRIAN MANNING, MICHAEL KELLEHER FRCSI, Senior Specialist Registrars in Surgical Training, Irish Higher Surgical Training Group Committee, Royal College of Surgeons of Ireland, Dublin 2.