Total number of hours worked by middle grade doctors

5.11  Senator S.C. Ferguson of the Minister for Health and Social Services regarding the total number of hours on duty undertaken by Middle Grade doctors.

What was the number of hours on duty undertaken by each of the 57 middle grade doctors for the period from 9.00 a.m. on 6th June 2011 to 9.00 a.m. on 13th June 2011, and did any undertake periods of continuous duty lasting more than 24 hours?

The Deputy of Trinity (The Minister for Health and Social Services):

This is a complicated question. I am unable to provide this information at present here and now because Health and Social Services did not simply have the capacity to respond in the time available. My officers have to trawl through dozens of rotas and then assess for each of the 57 doctors who was present, who was on leave, who was sick, et cetera. It will take some time and will divert officers from important work but as soon as it is available it will be forwarded to all States Members. Just to recap, this year alone my department has answered 7 questions directly relating to middle grade doctors, a significant number from the Senator herself. Apparently from her sources it is at odds with information already provided to you by this Assembly.

[11:00]

If this is the case then I urge the Senator to provide me specific details, not of the sources, but of the incidents that she believes was a cause for concern, because it will save us precious resource.

1. Senator S.C. Ferguson:

A supplementary. As the Minister full well knows I have undertaken to meet with her to discuss this. I thank her for her answer, but has she any knowledge of doctors undertaking more hours on duty during weeks when colleagues are on annual or study leave or is this information not available?

The Deputy of Trinity :

As I said, the information will be there but it will take quite a while to trawl through all the voters. If she can be more specific to one specific area that will help us enormously and I welcome that meeting.

2. The Deputy of St. Martin :

When doctors undertake extra hours on duty to cover the on-call duties of colleagues on leave; is this on a voluntary basis or is it compulsory?

The Deputy of Trinity :

I would have thought it is on a voluntary basis. They have to cover, as we have to provide 24 hours/7 cover. As you know, middle grade doctors, as all doctors and nurses, go on training, have sick leave, go on holiday. Rotas are not easy to do but they are overseen by the medical directors.

3. The Deputy of St. Martin :

Is there any evidence at all to show that if a doctor does not volunteer to do these extra hours that their card is not marked as being someone not co-operative?

The Deputy of Trinity :

Again, I am not aware of that but if the Deputy has that information, then please come and see me.

4. Deputy A.E. Jeune :

I am quite amazed that we cannot get this information quite readily; pay systems usually do. But where the shift length exceeds 24 hours, how many hours may the doctor be continuously on duty? Could the Minister advise, please?

The Deputy of Trinity :

If I remember rightly, I have been asked that question before in a written question. Jersey Employment Law requires one day off in 7 days or 2 off in 14 days. Where the European Working Time Directive is, our trainee doctors comply to that because they are programme managed by the Wessex Deanery but we do comply to the local employment laws.

5. Deputy A.E. Jeune :

Is the Minister aware that when a 24-hour shift is finished, some doctors are entitled to a rest period, whereas others have to carry on working through the day until 5.00 p.m. or 6.00 p.m.?

The Deputy of Trinity :

If I understand it correctly, if they have 24-hour cover then they are entitled to some days off. They are entitled to one day off in every 7 days and 2 in 14 days.

Deputy A.E. Jeune :

But that means somebody could be working 2 or 3 24-hour shifts, listening to what the Minister is saying, and on the 7th day you may rest.

6. Deputy D.J. De Sousa:

The Minister, in her reply to the questioner, said that she needs more specifics. How more specific can the question be than have from 9.00 a.m. on 6th June to 13th June at 9.00 a.m.? That is specific timing. Surely the rota is on a computer system; punch in the date and time and the information should be there.

The Deputy of Trinity :

I wish it was that easy but our computer systems are unfortunately behind the times. It is not that easy, because there are 57 doctors and you have to know who are present, who is on leave and who was sick, et cetera.

7. Deputy D.J. De Sousa:

How much then is invested in a computer system that does not give the information?

The Deputy of Trinity :

I stand by that. We will provide States Members with that information before the end of the month.

8. Deputy M. Tadier :

Were this question time being conducted in French, it would be a farce worthy of Molière. Are we really to believe that this information about how many hours staff have worked during a certain period of time is not available? My question would be, how on earth does the H.R. Department at the hospital know how much to pay these staff [Approbation] if they do not know which hours they have been working? Will the Minister acknowledge that this is a complete nonsense; that the information is available and it is being withheld, perhaps by civil servants, for politically-charged reasons, just like the last Minister who refused to give information?

The Deputy of Trinity :

I wish I could provide that information. We have just had 2 days and there are 57 doctors. Some of the middle grade doctors' provision is out of hours; some is on-call, some of them stay in the hospital in the high-risk areas such as the Registry Department, General Medicine and Intensive Care but some of the residents do on- call from home. All of that has to be assessed. I wish it could; I wish it was as simple as pressing a button but it is not and I have given my undertaking that I will provide that information to Senator Ferguson and the rest of the States Members.

9. Senator S.C. Ferguson:

In the Verita statement it said: "It seems clear that on-call, middle grade doctors are more likely to be busy than on-call consultants. The weekly rotas show that registrars and staff grades were frequently on-call for 24 hours at a time. No doubt this is in line with tradition but perhaps not with modern views on patient safety or acceptable working practices." In view of the lack of information that the Minister has been given, can the department really be keeping track of the hours worked and complying with best employment practices?

The Deputy of Trinity :

Yes, we do keep on track but I can say it is not as easy as pressing a button. I will happily give that information to the Senator but it just needs time and it takes longer than just 2 days unfortunately.

Deputy T.M. Pitman:

I did not want to interrupt the Minister; I think it is a point of clarification. I think the figure that she was looking for was £11 million that has been invested, I think, if that helps Members. That is the right figure; that is how much we have spent so far.