Training needs of junior doctors

There is little doubt that the risks posed by exhausted medics making important decisions about care were significant and had no place in 21st century medicine. Both patients and doctors are safer now that these hours have been curtailed.

However, the introduction of the European Working Time Directive restricting junior doctors to a 48-hour week has presented its own problems, which could impact on patient safety both now and in the years ahead. The consequences need addressing.

Problems rostering doctors to fill shifts, particularly at night or weekends, are leaving gaps which doctors' leaders say mean staff are overstretched.

Temporary locum doctors are covering some absences but there are concerns about the quality of some staff and, of course, such ad hoc arrangements mean patients are denied continuous care.

Training is also being badly hit, with junior doctors not being given the time that they require to learn the advanced skills which will make them the specialists of the future. Surgeons are said to be among those worst hit, as they cover for colleagues instead of gaining vital time in the operating theatre learning from other specialists at work – the equivalent of pilots being asked to fly solo without gaining the necessary air hours.

In turn, this is putting increasing pressure on consultants who must spend more time carrying out duties which they might have delegated to junior staff in the past.

A Government report, pointing to the 60 per cent rise in consultant numbers in the last decade or so, has sensibly suggested specialists work more flexibly and take a greater role in out-of-hours services.

The problem in resolving the situation is that this will cost money in a climate when finances are already tight, irrespective of the claims that the NHS budget is being ringfenced.

Patient safety must be the highest priority now and always. Today's trainees must be given the time they need to ensure the specialists of tomorrow develop the standards of excellence for which British medicine has become internationally renowned.