by mary O’Connor
The 300 junior hospital doctors in Co Galway who took to the picket line on Tuesday in a one day protest over their “dangerously long working hours” reported an overwhelmingly positive response from the public to their demonstration.
Eighty non consultant hospital doctors (NCHDs ) were picketing outside University Hospital Galway at one stage during their day of action against the HSE which involved withdrawing services in public hospitals. It began at 7am and continued until midnight and represented an escalation in the long running Irish Medical Organisation’s 24nomore campaign.
The doctors are routinely required to work individual shifts of more than 24 hours at a time and up to 100 hours a week. They say this is detrimental to patients and themselves. The Government acknowledges that the hours worked by the NCHDs are in breach of the European Working Time Directive.
Doctors on the pickets reported strong support for their campaign from both members of the public and hospital colleagues. Motorists hooted their horns in solidarity with the protesters as they drove by UHG, passers-by stopped to offer support and local businesses ensured the placard bearers were well fed.
Hospital colleagues also voiced their support for the first national strike by non consultant hospital doctors in nearly 25 years which resulted in a scaling back of activities at local hospitals, include the postponement of a number of out-patient clinics.
Dr Lisa Cunningham Guthrie, a member of the Irish Medical Organisation’s NCHD committee and a doctor at UHG’s emergency department, told this newspaper that the doctors on the picket line outside the hospital had a “brilliant response” from the public.
“A lot of people were giving us sweets and coffee and Supermac’s and Mr Waffle brought over food. The hospital’s in-house canteen brought us out wedges and the nurses gave us sweets and notes of support. The support of the consultants in Galway was amazing. Nobody was negative, I haven’t met one person who had anything bad to say about the strike. Everyone knows [about the long hours NCHDs work] and if you are a patient you see it in hospital.”
Dr Cunningham Guthrie, who is seven months pregnant, works 12 hour shifts daily and this can be the case for seven days in a row. She could work up to 86 hours a week.
She says the long hours NCHDs work are “absolutely horrible”. “You are absolutely exhausted and you can’t think straight,” says the Ballina born medic. “You are irritable, you can’t think properly and when you come home at 5pm or 6pm you grab your dinner or breakfast and go straight to bed so you can get up for work. It’s never ending.”
She outlines she reached “breaking point” while based in Portlaoise. She has worked three 36 hour shifts in addition to her normal working week.
“I got really upset, I was crying, I felt I was getting depressed. I was going to quit as it was taking its toll on me. We, the doctors, stood up in February and we rejigged rosters. We didn’t get extra staff but this [rejigging] can be done in some cases without extra staff.”
Patient safety at risk
Patients’ safety is being put at risk by doctors working these long shifts, she maintains. There is a high incidence of mistakes being made, particularly in relation to medicine doses, she claims. Fortunately, nurses usually re-check the doses and spot any errors in time. Errors of judgment occur, as well, she says. Up to 36 per cent of doctors who intend to leave Ireland will do so because of working conditions and hours, she adds.
“You can’t look after patients properly if you can’t look after yourself. During the day when you are at your best it’s not too bad but at night it gets worse.
“There are quite a lot of errors, especially in relation to medicine doses but they are usually picked up. Your own rapport with the patient is affected, too. How can you get a proper history of a patient, for example a heart attack patient, at 3am when you are half asleep? One doctor told me he was called to see a patient at 2am while working a 36 hour shift. All he could think about was his bed. He thought the patient was quite well however she went on to have a heart attack. Fortunately she was saved. He was too tired to think of the questions to ask to form a medical assessment. Something like this could happen to every single doctor.”
She singles out James Keane, the head of human resources at UHG, for special mention, saying he has been “quite active” in reducing the NCHD’s hours in Galway.
“He’s really transformed Galway [hospital] in two and a half years. He is good and has made Galway a place where doctors want to work.”
However, even though the situation at UHG is better than in many other hospitals there are still “lots of problems” with the working week which can run to 86 hours, she admits.
Dr John Donnellan, the hairman of the NCHD committee of the IMO, claims that the HSE was responsible for the withdrawal of services at public hospitals.
“Responsibility for this day of action rests fairly and squarely with the HSE who have abused the position of NCHDs for over a decade. Throughout that time they have misled doctors, they have broken promises and commitments and they have ignored their obligations under EU law. As a result they are presiding over an unsafe working environment where the health of patients and that of our own NCHD colleagues is routinely put at risk.”
In a statement the HSE West said all hospitals in the West/North West Hospitals Group coped with the reduced number of rostered NCHDs on Tuesday. In preparation for the strike, the level of planned activity was scaled back to match the available resources.
Tony Canavan, the chief operating officer of the health authority, said as far as possible it tried to minimise the disruption to patients during the strike.
“However, due to the important role that NCHDs play, it was not possible to run the hospitals at full capacity. A number of outpatient clinics were postponed and we will be rescheduling these appointments as soon as possible. I would like to thank our patients for their understanding.”
Meanwhile the NCHD committee of the IMO met yesterday (Wednesday ) to consider developments in their dispute with the HSE. The Labour Relations Commission has invited the organisation to attend talks in relation to the dispute and it has agreed. This followed the receipt of a letter from the HSE saying it accepted the need for financial sanctions to be in place to prevent excessive working hours.
An IMO spokesman said “the ball is now in the HSE’s court if they wish to avoid an escalation of the dispute”.