John Deasy (Waterford, Fine Gael)
Link to this: Individually | In context

Question 103: To ask the Tánaiste and Minister for Health and Children the progress to date on the implementation of the European working time directive; and if she will make a statement on the matter. [9499/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
Link to this: Individually | In context

As the Deputy will be aware, the provisions of the European working time directive as it relates to the working hours of doctors in training came into force on 1 August 2004. The relevant provisions were transposed into Irish law by way of the European Communities (Organisation of Working Time) (Activities of Doctors in Training) Regulations 2004.

Employers and the Irish Medical Organisation have been engaged in discussions for some time under the auspices of the Labour Relations Commission, LRC, in order to advance proposals to effect a reduction in the working hours of non-consultant hospital doctors, to conform with the provisions of the European working time directive, EWTD. While some progress has been made, much remains to be resolved. The LRC has requested that both parties refrain from engaging in any form of unilateral action for the duration of the negotiation process. As a result, health employers have not acted unilaterally in order to achieve full compliance with the EWTD. In many sites around the country, the introduction of new rosters would facilitate significant progress towards EWTD compliance while maintaining safe patient care and existing levels of service provision. However, health employers, in response to the request of the LRC, are at present awaiting agreement between management and the IMO at national level before proceeding.

The ability of the Health Service Executive to effectively implement the European working time directive for the benefit of all NCHDs is dependent on the full cooperation of the Irish Medical Organisation at both national and local level. This process was delayed for some time in the absence of agreement by the IMO to the establishment of local implementation groups in each hospital and a national implementation group to coordinate and direct the work of the local groups.

Agreement was finally reached with the IMO in late 2004 to the establishment of nine pilot sites. The work by the local groups at these sites is progressing with a view to developing plans for the full implementation of the directive.

Local implementation groups at nine pilot sites are examining local implementation issues and developing plans for the full implementation of the directive. Each local implementation group includes consultants, local representatives of training bodies, NCHDs, nurses, management and other grades. The work of the groups is well underway and it is intended that they will document how measures to reduce or reorganise NCHD hours can best be implemented. Action can then be taken on foot of this information when the industrial relations issues have been resolved. At the current time each group is engaged in or beginning a comprehensive analysis of hospital activity. The data gathered from this exercise will help determine how we begin to reorganise services over a 24 hour day to maintain high quality patient care while achieving compliance with the directive.

In the UK, a similar project, the Hospital at Night project, allowed health employers, the British Medical Association and the training bodies to redefine how medical cover is provided in hospitals during the out-of-hours period, including evenings, weekends and holidays. The project identified the core competencies required to staff the hospitals during the out-of-hours period and used these to develop EWTD compliant staffing models which are clinically sound and acceptable to patients, the public and staff.

Further negotiations on issues relating to industrial relations matters will take place under the auspices of the LRC, aided and informed by the information compiled by these pilot local hospital groups.

In addition, both sides have accepted a proposal made by the LRC on 7 February 2005 for the establishment of a national implementation group, whose membership will include the Department of Health and Children, the Health Service Executive, the Irish Medical Organisation, the Irish Hospital Consultants Association, the Postgraduate Medical and Dental Board, the Medical Council, the postgraduate medical training colleges and representatives of nurses and other healthcare professions. This group will co-ordinate the work of the existing nine pilot hospital local implementation groups, issue agreed guidance on matters related to the implementation of the EWTD and assist in the development of local implementation plans.

Finally, management and the IMO have also agreed to recommence substantive negotiations on the NCHD contract. A meeting in this regard took place on 16 March at the LRC and a further meeting has been arranged by the LRC for 11 April 2005. In this context, I am hopeful that early progress can be made in resolving outstanding issues, so that full implementation of the directive's requirements can proceed without further delay.