Letter: Junior doctors overstretched by hours cut

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Sir: The comments of David Wrede ("Ministers want doctors to work 83-hour weeks", 28 November) are not shared by the majority of doctors, particularly in the surgical specialities. The reduction of additional worked hours from a previous average of 43 a week to a proposed 16 is impractical, since the workload in the hospital remains unchanged and the number of junior doctors has failed to rise significantly.

Junior doctors now find that during an on-call period they are suddenly responsible for the acute care of two to three times as many patients as in the past. These patients may be from a variety of different medical specialities the doctor is not normally familiar with.

The shift system that has been introduced in some hospitals results in particularly unsocial hours and working many more weekends and evenings than previously. Junior doctors slightly higher up in the ranks have to perform duties which are not appropriate to their experience, gained over several years of qualification; this prevents the natural development and progress of clinical skills.

The new deal means junior doctors working harder while on call. Now there is no chance of sleep. If anything, patients are going to be at greater risk from junior doctors working more intensely in more stressful circumstances than ever before.

To crown it all, there has been in real terms an absolute pay reduction because we are working fewer hours.

Unless there are more junior doctors there can be no easy way of reducing hours. It would be better to admit that we have to work long hours, and provide appropriate support. The majority of junior doctors are intelligent, hard-working and motivated people who entered medicine to make a professional career, and not to be reduced to the level of a clock-on, clock-off production- line system.

S A WAJED

Registrar

Department of Surgery

The Whittington Hospital

London N19

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