The NHS European Office is heavily involved in discussions between the European social partners (employers' representatives and the trade unions) on options for reviewing the existing and controversial working time rules.
This review follows the conclusion, without agreement, of previous attempts to revise the European Working Time Directive (Directive 2003/88/EC). In an attempt to break the impasse, the Commission decided to carry out a comprehensive review of the working time rules, and the social partner dialogue forms part of this.
Negotiations between the Social Partners
The European social partners have now written to the European Commission confirming their intention to open formal negotiations on revising the legislation. This is an important announcement after years of failed discussions and negotiations will specificially focus on the problematic European Court rulings on on-call time and compensatory rest.
The NHS European Office is a leading member of the negotiating body representing public sector employers across Europe (CEEP), which will be representing the voice of the NHS in these discussions.
These negotiations provide an opportunity to reach an agreement on behalf of front-line staff, those who most understand the real-life practical implications of the proposals. They also have the potential to reach a common-sense solution that is best for all parties.
For more information on the social dialogue process, and the social partners themselves, please visit this web page.
Responding to the Consultation
The NHS European Office worked with NHS Employers and others across the NHS throughout the earlier consultation period and submitted a response to the second stage consultation on behalf of the NHS at the end of February 2011.
A decision about the Working Time Directive remains a long way off and NHS organisations must continue to comply with the existing Working Time Regulations until then. For more information and tools to support compliance see the working time directive page and the Healthcare Workforce Portal.
You can also view a presentation on the Working Time Directive given by the NHS European Office at the recent NHS Employers Annual Conference.
Key points of the response
• Health services have to be provided on a 24-hour basis. Both for their own safety and for that of their patients it is critical to reconcile the need for healthcare workers to have adequate rest, with the need for flexibility about how working time rules are implemented on the ground.
• The narrow interpretation by the European Court on the rules, notably around “on-call” time and “compensatory rest”, has impacted adversely on staffing levels, costs and time available for patient care. Hospitals have had to employ extra doctors and other staff, at considerable cost. Many have had to rearrange working patterns completely to avoid situations such as cancellation of clinics and outpatient or inpatient procedure lists at short notice. The response says continuity of care can be badly affected if there are frequent handovers, and trainee doctors have less time to learn valuable skills.
• NHS trusts are supportive of proposals to introduce an EU framework that sets out key principles and takes the specific needs of different sectors into consideration. This would allow the NHS to implement the rules more flexibly, taking account of local needs and practices, while at the same time ensuring the health and safety of the workforce. Trainee doctors would have more time to learn how to carry out procedures, so both staff and patients would benefit.
• It is important for patient care that individual healthcare staff should maintain the right to seek an opt-out from the 48-hour ceiling on working hours so that the NHS can provide a properly staffed service. The majority of EU member states have had to make use of the opt-out to ensure compliance with EU law.
Next steps
It is difficult to predict the length of time which the Social Partner negotiations will take or indeed whether they will reach some form of agreement. If there is no agreement then the European Commission will likely propose new legislative proposals which will pass through the EU's usual co-legislative procedure.
The House of Commons European Scrutiny Committee has also debated the review of the Working Time Directive on several occasions. The European Office will continue to inform decision-makers on both sides of the channel of the views and concerns of the NHS.
The timescales involved in the process for revising the legislation are expected to be long. The NHS European Office and NHS Employers will keep NHS organisations updated on further developments and their implications for the healthcare sector and its workforce through this page and the weekly NHS Workforce bulletin.
European Commision warns Ireland and Greece over 'excessive hours'
The European Commission has warned both Ireland and Greece that they must ensure full compliance with the governing European Working Time Directive or face significant consequences.
Ireland and Greece now have two months to inform the Commission of measures they have taken to bring their legislation into line with EU law. Otherwise, the Commission may decide to refer Ireland and Greece to the EU's Court of Justice.
In Ireland's case, national law provides for limits to doctors’ working time, but a European Commission notice states that in practice public hospitals often do not apply the rules to doctors in training or other non-consultant hospital doctors. They claim there are still numerous cases where junior doctors are regularly obliged to work continuous 36-hour shifts, to work over 100 hour in a single week and 70-75 hours per week on average, and to continue working without adequate breaks for rest or sleep.
For Greece, the notice claims that doctors working in public hospitals and health centres often have to work a minimum average of 64 hours per week and over 90 hours in some cases, with no legal maximum limit. There is no legal ceiling to how many continuous hours they can be required to work at the workplace, and they often have to work without adequate intervals for rest or sleep.
How you can stay involved
The NHS European Office is continuously seeking the views of NHS bodies to ensure that the views we put forward for the revision of the Directive reflect real concerns of the NHS. We also want to ensure our negotiating position on this important issue is backed up by hard evidence. Our ultimate goal is to ensure a positive outcome for patients by ensuring that the NHS has the flexibility it needs to deliver round-the-clock services, whilst also safeguarding the health and safety of our staff.
Please send your views and comments to kate.ling@nhsconfed.org