Junior Hospital Doctors: Working Hours (Hansard, 9 November 1989)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper)
My Lords, I assume the Question refers to the Government's initiative, launched in June 1988, aimed at reducing junior hospital doctors' rotas which are more onerous than one in three. Final reports on the initiative have just been received in the department and will need to be carefully analysed.

§ Lord Ennals
My Lords, my Question concerned a report commissioned two years ago which was received in the department in August and which I hope will be published. Will the Minister give an explanation as to why there is a discrepancy between assurances given during the passage through this House of the Bill of my noble friend Lord Rea that the situation of overworked junior hospital doctors was improving and the report's finding, which the noble Baroness will see when she reads it, that five hours extra per week are worked, particularly by casualty doctors and obstetricians?

§ Baroness Hooper
My Lords, the department commissioned a research project in 1985 known as the Dowie project. The field work was carried out in 1987. We pre-empted the results of that with our June 1988 initiative and, indeed, the other pilot studies initiative which has been launched.
The results of the survey show that extremely long hours are worked in some grades and specialties with very short periods of rest at house officer level. That bears out the Government's decision to launch the 1988 initiative which, as I say, we took before any results came through. However, so far we have received an interim report and my right honourable 941 friend the Secretary of State is considering whether it is appropriate to publish it.

§ Lord Molloy
My Lords, can the noble Baroness say whether or not the recruitment of junior hospital doctors is improving?

§ Baroness Hooper
My Lords, we believe that the career possibilities for junior doctors are very relevant to recruitment. Of course, as the noble Lord knows, health authorities are responsible for determining the number of consultants required to meet service needs. Their strategic plans indicate an annual increase in consultants' numbers averaging 2 per cent. per annum.
In addition, Achieving a Balance —a 10-year plan to reform hospital medical staffing —aims to improve both the quality of service and junior doctors' careers by increasing the number of consultants and by bringing the numbers in training in each specialty into line with further consultant opportunities. The Government have recently announced the creation of 100 new consultant posts in the National Health Service.

§ Lord Ennals
My Lords, in the view of the interest shown by your Lordships' House, as demonstrated by the Bill which passed through it, does the Minister not agree that that information should be made public and that it is not something which the department should keep to itself? Does she not agree that this issue concerns the public who will wish to be informed about it?

§ Baroness Hooper
My Lords, I recognise the interest in this matter, particularly in your Lordships' House. Indeed, I reiterate that the initiatives already introduced by the Government fully meet the concerns which have been expressed; that is, the June 1988 initiative and the pilot studies initiative. However, I feel sure that my right honourable friend the Secretary of State will take all considerations into account in reaching his decision.

§ Lord Auckland
My Lords, does my noble friend have any figures as to the comparison between teaching hospitals and the district general hospitals where junior doctors are sometimes working quite exceptionally long hours?

§ Baroness Hooper
My Lords, not without notice. However, from the evidence of the initiatives, we know that substantial progress has been made in reducing onerous rotas. We now need to consider how best to further reduce the remaining onerous rotas. I believe that that is where the pilot studies will be of particular assistance.

§ Baroness Robson of Kiddington
My Lords, does the Minister agree that the Government's agreement to sanction another 100 consultant posts is completely different from their actual appointment by health authorities which at present do not have the money to appoint those extra consultants?

§ Baroness Hooper
My Lords, not at all. I believe that in responding to the question about the potential career possibilities for junior doctors, the end number of posts available is very relevant.

§ Lord Kennet
My Lords, can the Minister say whether or not the appointment of junior hospital doctors is improving?

§ Baroness Hooper
My Lords, from the noble Lord's question I am not sure whether he is talking about the improvement of quality or numbers of junior doctors. I understand that the numbers are not increasing, and I very much hope that the quality is improving.

§ Baroness Phillips
My Lords, can the Minister indicate from the survey which she has seen that the hours of junior doctors are far longer than almost any other workers within the hospital structure?

§ Baroness Hooper
My Lords, yes. As I tried to say, the history of this matter goes back to 1981 to a short report by the Select Committee in another place. It was as a result of insufficient progress in that area that the Department of Health commissioned research in 1985 and is taking the additional initiatives.

§ Lord Jenkins of Putney
My Lords, the noble Baroness told us that the number of junior doctors is not increasing. Is it static, or is it reducing?

§ Baroness Hooper
My Lords, I believe that it has levelled off.