Intended for healthcare professionals

Rapid response to:

Feature European Working Time Directive

Running out of time

BMJ 2009; 338 doi: (Published 14 April 2009) Cite this as: BMJ 2009;338:b1507

Rapid Response:

Juniors can opt-out of 48-hour limit

The European working time directive (EWTD) has two elements: it
demands that every worker has regular rest (11 in every 24 hours), and it
limits average weekly work to 48 hours. The Directive makes the former
mandatory with no flexibility - and this is its really big contribution to
safety - but it allows every worker to opt-out of the 48-hour limit.

In Britain, many professional workers already exercise their choice
to opt-out of the working hours limit – but, for some unknown reason, the
Department of Health does not support this approach for junior doctors.
Hence, the majority of juniors now are confined to a 48-hour week, which
decimates continuity of patient care, endangers patients, decreases
teaching, and lowers hospital efficiency.

However, the good news is that all junior doctors (like all other
adult UK workers) are fully eligible to opt-out of the 48-hour limit, and
return immediately to the 56-hour week allowed by the New Deal. The
Department of Health must promote this option.

By the use of innovative online rostering, such 'opt-out' rotas
provide a stable and practical local solution to the 48-hour week. The
additional eight hours allows employers to hire legally their own juniors
to act as internal locums, helping to solve the current severe problems
due to the lack of available external locums

Competing interests:
Roy Pounder is asssociated with

Competing interests: No competing interests

19 April 2009
Roy E Pounder
Emeritus Professor of Medicine
Cirencester GL7 7JA