Ms Shirley Coulter:

With regard to Deputy Regina Doherty's point to the effect that it cannot be as straightforward as stating that nothing is changing because there is no sanction or accountability, what is happening is endemic in the system. It has been the way things are for so long. However, this does not mean that it should continue to be the way. It is certainly because of the lack of accountability or sanction that things are not changing. At the end of the day, the interests of hospitals relate to throughput of patients and for patients to be looked after and discharged. That is continuing to occur. As long as this is the case and as long as hospitals remain within budget, those in authority in the hospitals have, in their view, realised their duty of care to patients. They are, however, missing the point when it comes to their duty of care to their staff and to the doctors who deliver the care in question. They are also missing the vital point that in the context of patient care, it is not safe to have tired doctors. As Dr. Considine stated, these adverse events are happening but they are not being openly and publicly attributed to people's working hours. They are happening and perhaps it is time to stand up. This is not about pointing figures or blaming individuals but everyone must be made aware of the implications of long working hours in respect of patient care. It is also time there was accountability for this at hospital level.