Irish patients are being treated by hospital doctors who spend as little as 4 per cent of their time being trained, a report published yesterday reveals.
Some are working an average of 89 hours a week, according to the report of the National Joint Steering Group on the working hours of non-consultant hospital doctors.
The report recommends measures to implement an EU directive to reduce the working hours of junior doctors, to have consultants working around the clock and to ensure doctors are getting the training they are supposed to receive.
It was welcomed yesterday by the Minister for Health and Children, Mr Martin, who is to bring it to Government with the report of the Medical Manpower Forum.
The Irish Medical Organisation welcomed the report, but warned any changes affecting consultants would have to be negotiated and agreed. It also said it would not start talks on the report until all hospitals had implemented last July's agreement to improve NCHD working conditions.
The steering group was set up in June 1999 and is made up of nominees of the Health Service Employers Agency and the IMO.eal. Its main purpose was to recommend how to implement an EU directive which means the working week of NCHDs must be reduced to 48 hours by 2010.
While there has been increasing dissatisfaction in recent years - expressed by the Medical Council among others - at the inadequate levels of training being given to doctors, this report shows starkly just how inadequate that level of training is.
"Although it is recognised that training should be an inherent part of the NCHD's daily routine, currently they spend an average of only 4 per cent of their working day studying or in receipt of formal training," it says.
The demands on the health services mean "consultants have limited time to provide any form of structured training and NCHDs are often too busy to attend that which is provided".
It adds: "Many NCHDs feel that they are inadequately trained to carry out the operations and procedures that they are expected to perform."
NCHDs are working an average 77 hours a week and in some specialities it is far higher. In surgery, the average is 89 hours a week, in anaesthetics it is 84 hours, in obstetrics and gynaecology 83 hours, and in radiology/pathology 82 hours. The lowest working week is in Accident and Emergency at 51 hours.
To rectify the situation, the report says a minimum number of work-based hours with the training consultant should be part of every NCHD's roster. A guarantee of a quality training programme could help to keep medical graduates here who now go abroad to further their medical education, it says.
It also seeks a change from a consultant-led hospital doctor service to a service provided by consultants. This means more consultants working round the clock and proportionately fewer NCHDs. This has been accepted in principle by the IMO and the Irish Hospital Consultants Association, but its implementation will require detailed negotiation.
It will also require talks with nurses, paramedics, administrative staff and porters, all of whom will see their work patterns changing as a result of the move to a consultant-provided service. For instance, to allow doctors to concentrate on the work they are trained to do, phlebotomists may have to be available at all times to do blood tests which doctors would otherwise have to do.
The report recommends a national task force to implement its recommendations. This task force would co-ordinate its efforts with local working groups at hospital level.
pomorain@irish-times.ie