Ms Angela Fitzgerald:

All consultants have an on-call commitment. The frequency of call depends on the size of the team. Cardiology was referred to. If there is a team of five cardiologists, for example, in those circumstances one's frequency of call would typically be one in five. One of the challenges, which was referred to earlier, is that in many smaller hospitals, the number of people on a team is quite small so because of that the frequency of call is very significant. That does not get captured as part of the 39 hours. It is accepted as a requirement over and above it. It means if one is in an area where one could be called in, as Mr. Woods mentioned with regard to cardiology, one could find oneself frequently having to come back to the hospital overnight and then do one's day's work. It comes back to the number of consultants we have and the distribution of those consultants. It is well understood and accepted that we have fewer consultants than corresponding OECD countries. We are well down on the number of consultants per head of population. One of the objectives for us is to grow the number of consultants we have rather than rely on junior doctors, which has been a feature. The on-call arrangements are specified by site. It is a contentious issue. When I worked in St. James's Hospital, when we changed to the specialty-take model, one concern was the frequency of call would increase for some people, which means they are up overnight and back in the next morning. The broad terms are prescribed by the contracts and the specifics are site-specific, depending on the number of people in individual teams and whether one works in a clinical directorate. It is fair to say that when consultants are on call, they are expected to take calls from junior doctors and to come in and do post-take ward rounds. If I am on call tonight, I could get a number of calls from junior members of the team. I may be called in if I am a surgeon and the following morning, I will come in and do a post-take ward round. That happens initially in the emergency department and for anyone who is admitted overnight. It is over and above one's prescribed duties in one's work practice plan.