Intended for healthcare professionals


Outcomes of the European Working Time Directive

BMJ 2008; 337 doi: (Published 31 July 2008) Cite this as: BMJ 2008;337:a942
  1. Hugh Cairns, consultant nephrologist,
  2. Bruce Hendry, professor of renal medicine,
  3. Andrew Leather, consultant surgeon,
  4. John Moxham, professor of respiratory medicine and medical director
  1. 1Renal Administration, King’s College Hospital, London SE5 9RS
  1. hugh.cairns{at}

    From 56 to 48 hours is a step too far

    The European Working Time Directive was produced by the Council of the European Union in 1993 and incorporated into British law in 1998 as the Working Time Regulations.1 Various aspects of the directive have had a major effect on the practice of medicine in the United Kingdom, most importantly the reduction in the maximum working week to 56 hours in 2007, a planned further reduction to 48 hours in 2009, and the need for a minimum of 11 hours’ rest in any 24 hour period.

    Although not clearly stated in the directive, the aims of the council presumably were to protect workers from being coerced by employers to work excessive hours; to improve the quality of life of workers by permitting sufficient free time for family and leisure; and to reduce risk caused by tired workers. Although many industries are affected by the change in the law, medicine poses particular problems because of the need to train junior medical staff and to provide a 24 hour service that can respond to variable demand while ensuring continuity of, often complicated, patient care. Furthermore, unlike many other professions, junior and now senior doctors are paid per hour, which exposes the length of the working day and week to legislation.

    If the directive was meant to improve clinical care and the quality of life and training for junior medical staff, its effect has been the opposite. The changes to working hours have had a major negative effect on the working life, free time, and education of …

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