New category of on-call work suggested
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《英国医生杂志》
The European Commission is challenging the medical profession and public health authorities to agree to create a new category in existing working time legislation to cover doctors on call.
This would define the inactive periods spent on call and would be in addition to the two current categories that divide time simply into "work" and "rest."
Securing an agreement between doctors and their employers will be difficult. It will not be made easier by the fact that the commission has deliberately left unsaid whether its call for a definition of "inactive on-call time" would apply to periods spent on site in a hospital or off site at home.
The BMA maintains that periods spent compulsorily resident in hospital should be treated as working time, as at present. It also agrees that time spent not working while at home should not be classed as working time.
It argues that the third definition, however, could apply to these non-resident periods, which are currently classified entirely as rest.
Simon Eccles, the chairman of the BMA抯 junior doctors?committee, believes they involve a mixture of work and rest. "After all, you cannot relax entirely. You have to stay sober, not go too far from the hospital, and be contactable at all times," he points out.
The British government has given a non-committal reaction to the commission抯 support for negotiations between the partners, although it is likely to consider that "inactive on-call time" should apply to on-call periods spent on site, rather than at home.
In a brief statement, it called for rapid legislative solutions to the problems that have been raised and stated its determination "to ensure that national health services do not suffer."
The reference to legislation suggests that it is not expecting to reach a deal with the medical profession. The commission has given the social partners six weeks to decide if they can negotiate a collective agreement. If they believe they can, they have nine months in which to finalise it. If they cannot, the commission has confirmed it will bring forward legislation.
The attempt to agree a more precise, third definition is part of moves towards a more general overhaul of the 10 year old legislation setting a maximum 48 hour working week. It is also a response to a far reaching ruling from the European Court of Justice last September.
The Luxembourg based judges noted that when a doctor is required to be available at the place determined by his employer, he could not be regarded as being at rest during the periods of his on-call duty even when he is not carrying out any professional activity (BMJ 2003;327:640)
The German government estimated that the ruling could cost up to �2bn (?.3bn; $2.4bn) and require 20 000 more doctors. Since the judgment, France, Spain, Germany, and the Netherlands have begun to apply the opt-out clause from the legislation to their health sectors.(Brussels Rory Watson)
This would define the inactive periods spent on call and would be in addition to the two current categories that divide time simply into "work" and "rest."
Securing an agreement between doctors and their employers will be difficult. It will not be made easier by the fact that the commission has deliberately left unsaid whether its call for a definition of "inactive on-call time" would apply to periods spent on site in a hospital or off site at home.
The BMA maintains that periods spent compulsorily resident in hospital should be treated as working time, as at present. It also agrees that time spent not working while at home should not be classed as working time.
It argues that the third definition, however, could apply to these non-resident periods, which are currently classified entirely as rest.
Simon Eccles, the chairman of the BMA抯 junior doctors?committee, believes they involve a mixture of work and rest. "After all, you cannot relax entirely. You have to stay sober, not go too far from the hospital, and be contactable at all times," he points out.
The British government has given a non-committal reaction to the commission抯 support for negotiations between the partners, although it is likely to consider that "inactive on-call time" should apply to on-call periods spent on site, rather than at home.
In a brief statement, it called for rapid legislative solutions to the problems that have been raised and stated its determination "to ensure that national health services do not suffer."
The reference to legislation suggests that it is not expecting to reach a deal with the medical profession. The commission has given the social partners six weeks to decide if they can negotiate a collective agreement. If they believe they can, they have nine months in which to finalise it. If they cannot, the commission has confirmed it will bring forward legislation.
The attempt to agree a more precise, third definition is part of moves towards a more general overhaul of the 10 year old legislation setting a maximum 48 hour working week. It is also a response to a far reaching ruling from the European Court of Justice last September.
The Luxembourg based judges noted that when a doctor is required to be available at the place determined by his employer, he could not be regarded as being at rest during the periods of his on-call duty even when he is not carrying out any professional activity (BMJ 2003;327:640)
The German government estimated that the ruling could cost up to �2bn (?.3bn; $2.4bn) and require 20 000 more doctors. Since the judgment, France, Spain, Germany, and the Netherlands have begun to apply the opt-out clause from the legislation to their health sectors.(Brussels Rory Watson)