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Junior Hospital Doctors (Conditions Of Service)

Volume 828: debated on Tuesday 21 December 1971

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asked the Secretary of State for Social Services what steps he is taking to reduce the number of hours worked a week by junior hospital doctors.


asked the Secretary of State for Social Services if he will reduce the number of hours stipulated as normal in a working week for a junior hospital doctor from 100 and thus extend the payment for overtime pay.

I have asked hospital authorities to do all they can, by improved organisation of medical work and in other ways, to reduce the long hours on duty and on call undertaken by many junior doctors. Extra-duty payments are related not to a normal working week but to minimum off duty time.

Does not the right hon. Gentleman agree that the present average of 88 hours a week worked by junior hospital doctors, as has been found in a recent report, can lead to low morale, inefficiency and even danger to patients? Will he therefore take steps to introduce a 40-hour week as recommended in the same report?

The report to which the hon. Lady refers is by now a little out of date, and I do not think we can be sure of the figures. I have therefore asked hospital authorities to make a return to me of the hours worked by, and other relevant details about, junior hospital doctors. I hope to receive this information during the coming year and to make use of it in guidance.

Is it not time that the right hon. Gentleman cut across the British Medical Association and got into direct communication with the Junior Hospital Doctors' Association on questions such as this? Would he try to do away with the problem involved in the system of on-call being regarded as one task and the actual hours of work another? Is it not ridiculous that they get no payment until they have been on call or on duty for 100 hours?

These are complicated issues. I have no reason to think that I am not getting the full facts, but I need more information. This is why I have sought it from the hospitals in the way I have described.

Is the right hon. Gentleman aware that I can give him evidence of doctors who are working 110 hours a week, who in some cases work 36 hours consecutively without going to bed, and who in such circumstances unfortunately can make serious mistakes? Is he further aware that the hospital involved could have advertised for additional staff but refused to do so, and therefore has not helped to reduce the shortage of staff, because it says that it has not enough money to cope with the situation?

There is an infinite range of situations. It would help if the hon. Gentleman sent me details. I hope that hon. Members will not describe as "at work" what is in effect a combination of being at work and on call. I do not minimise the importance of being on call, but it is not the same.

The right hon. Gentleman must be aware of a recent report which showed that an average of 88 hours a week was being worked by junior hospital doctors.

I think the hon. Lady is referring to the report which I have in my hand, which was carried out by the consultant division of my Department and which relates to three years ago.

Then perhaps the hon. Lady will send me details of what she has in mind.

In view of the unsatisfactory nature of the reply, I beg to give notice that I shall seek to raise the matter on the Adjournment at the earliest possible opportunity.


asked the Secretary of State for Social Services whether he will establish a committee of inquiry into the salaries and conditions of service of junior doctors.

An independent Review Body advises the Government on the remuneration of all doctors. Conditions of service are under continuous review by a joint negotiating committee consisting of representatives of the Health Departments and of the Negotiating Sub-Committee of the Central Committee for Hospital Medical Services, which includes representatives of junior doctors. I see no need for a new committee of inquiry.

Is the Minister aware that some consultants treat their housemen as shopkeepers in the 18th century treated their apprentices, and that there is need to ask the junior doctors themselves about the conditions under which they work rather than to ask the hospital authorities? Is he further aware that the remuneration paid to housemen is absolutely disgusting when compared with the remuneration of the consultants?

Of the 18 members of the Central Committee for Hospital Medical Services, four are from the Hospital Junior Staffs Group, and I expect that they make their voice fully heard on that committee.