`Sleep deprivation is a form of torture and it is very effective'

One message from the conference is that the working conditions of junior doctors will have to be changed

One message from the conference is that the working conditions of junior doctors will have to be changed. Dr John Macfarlane (28), a registrar at Cork University Hospital, describes his job.

"You are so tired that all you want to do is go to bed. Sleep deprivation is used as a form of torture and any junior doctor will tell you that it is a very effective method. You want to make sure that the patients don't die, but it is very hard to properly take care of them.

"Working conditions do depend greatly on what hospital you are in. At the moment, I have a 1/7 rota which is considered very good. However, when I am on call it is for 36 hours straight through. Today, in the hospital where I work, two people on the rota are off sick. Administration said they cannot find a locum so the guy who was on last night, who will have worked all the way through today, will have to do tonight as well.

"At the weekends in some hospitals junior doctors come in on a Friday morning and have to keep going until Monday evening, sometimes with no prospect of sleep. Maybe just getting an hour or two. You spend all the time trying to catch up with yourself, sometimes working up to 120 hours a week. Changes need to be made to the whole system.

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"Our contract was changed so that it would be as expensive to ask a junior doctor to stay on as getting a locum in to cover. But the hospitals are not honouring that. We are being asked to stay on and not being paid properly for it.

"The only realistic way I can see this changing is that junior doctors are paid proper overtime rates for the hours that they work by the hospitals.

"They will continue to force us to work long hours unless we make it financially punitive. Administrators only care about the bottom line, they couldn't give a damn about patient care.

"At the moment, I am working as a registrar in infectious diseases. The day starts around 8 a.m., the earliest you will get home is 6 p.m., but it is often much later; some people will work until 10 p.m.

"You see the patients first thing in the morning and then spend your time checking on test results, writing letters, prescriptions, answering bleeps, telephone calls, inserting drains, taking blood. There is no limit on the number of patients that can be in your charge, no correlation between manpower and the number of people to be treated. If it takes you until 10 p.m. to get through them all, then that's just tough luck.

"People vary as to how they are able to cope. That's why I am involved with the IMO, to try and make changes. There are laws for airline pilots and truck drivers but the Government is directly responsible for NCHDs [non-consultant hospital doctors] but they just won't do anything about it, even though it affects not just the welfare of doctors but patients also."

(In an interview with Alison O'Connor)