Working time directive and its impact on training

Abstract

The European Working Time Directive (EWTD) was first introduced in the United Kingdom (UK) in 1998 to all sectors of employment excluding the medical sector. It was gradually introduced to the medical sector in phases, starting from August 2004. The aim of the EWTD was to achieve a maximum of 48 h a week working time to help protect the health and safety of employees. In August 2004, a 58 h a week maximum limit was first introduced. This was gradually decreased to 56 h a week in August 2007 and eventually fell to the current 48 h a week in August 2009. The EWTD does not merely provide a maximum working hour limit per week. It also stipulates rest and break provisions during working hours. For junior doctors this includes an 11 h rest period in every 24 h, a rest break of 24 h for every 7 working days and a minimum of 20 min break in every 4 h of work. All these provisions are to standardize the work ethics of the NHS and protect both the doctor and patient from harm due to exhaustion. The primary goal of the EWTD is to protect the health and safety of workers and to prevent employees from being coerced by employers to work excessive hours; leading to a better worklife balance. It is also to ensure that workers are paid accordingly. Historically, junior doctors in Britain were exploited with work patterns that often required 80 or more hours on duty each week. These hours were remunerated poorly, with overtime initially not paid and subsequently paid at only 30% of the basic hourly wage. In 1990, only 10% of all UK employees worked 40 h a week. In Europe this figure was 34% (according to the Royal College of Surgeons, England). In the absence of legislation, it was possible for employers to avoid paying overtime altogether. What then is defined as work time? The SiMAP (Sindicato deMedicos de Astsencia Publica) ruling, by the European Court of Justice in 2000 states that time spent oncall by doctors in public medical emergency services where they are required to be at the health centre, must be regarded as working time and, where appropriate, as overtime. The Jaeger ruling in 2003 states that on-call working should be considered in