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OBSERVATIONS: Tessa Richards Wising up to Europe BMJ 2009; 338: b1090 [Full text]

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Europe matters

Alexander W. Macara   (27 March 2009)

Call for EWTD risk assessment

Roy E Pounder   (29 March 2009)

Europe matters 27 March 2009
Alexander W. Macara, Retired Public Health Physician At home BS9 2DH Send response to journal: Re: Europe matters	Tessa Richards makes a timely call for everyone involved in healthcare to take an active part in shaping the EU's policy. The BMA has done so since the U.K. joined what was originally the Common Market, and currently holds the presidency, under Michael Wilks, of the CPME ( the acronym for the French title of the Standing Committee of Doctors in the European Union) Sadly, there is a fundamental weakness on both sides. DGSanco, responsible for Consumer Affairs and Health ( appropriate bedfellows) has limited powers and an inadequate budget and medical representation is dispersed through an alphabet soup of bodies seeking to represent parts of the profession - GPs, specialists and hospital doctors, Juniors. The BMA has to be involved in all of them and is working to bring them all together with the CPME which should become the umbrella organisation on the BMA model. Urgent issues are being tackled such as free mobility of doctors, working time, cross-border healthcare, nutritional policy, control of tobacco and alcohol, climate change, advertising of drugs,and "e-health". Readers - in your own and all our interests- watch this space! Competing interests: None declared
Call for EWTD risk assessment 29 March 2009
Roy E Pounder, Retired Professor of Medicine Cirencester GL7 7JA Send response to journal: Re: Call for EWTD risk assessment	The European Working Time Directive was planned and introduced in 1993 without any risk assessment of its effects on European Healthcare or postgraduate medical education. Whilst implemented with the best of intentions, there are undoubted disadvantages for a system that requires many of its staff and their skills to work 24/7 – for example, broken continuity of care, less staff during ‘normal working hours’, and inadequate time for acquisition of skills. The European Commission is reported to have warned all, but two, countries of impending prosecution for failing to implement the EWTD for their junior doctors. It is a paradox that whilst parts of the Commission are pressing for improved Patient Safety in Europe, other parts are busy implementing regulations that, most observers concede, put in-patients at risk. Perhaps it is now time for every Government to demand that the Commission performs the formal risk assessment, which should have been performed 16 years ago? Competing interests: Associated with RotaGeek Ltd