Although the aim of the European Working Time Directive is to improve workers' safety and protection, it seems to have caused a collective headache for member states since its conception more than 10 years ago. The resulting debates and modifications have elevated this humble headache to a full blown migraine now that the directive has been extended to include doctors in training (p 310).1

In 1993 the European commission stipulated the minimal requirements to limit working time to a maximum of 48 hours a week by November 1996. For the medical profession, this included all doctors other than doctors in training. For various reasons, the United Kingdom lagged behind and the directive was not implemented until October 1998.

As the directive stands there is only work and resting—no in between such as on-call times, when the doctor may not actually be working. The commission is also concerned about the use of opt outs, which give individuals the right to opt out of the weekly limit on working hours. Doctors may opt out for various reasons, such as the need to earn more money or to receive more training, or simply due to pressure exerted by the trust they work for. The more doctors opt out, the easier it becomes for trusts to comply with …