Restrictions on doctors' hours 'compromise patient safety'

Britain's most senior surgeon has appealed to the Prime Minister to intervene to protect patients from inadequately trained doctors.

In a letter to Tony Blair, Bernard Ribeiro, president of the Royal College of Surgeons, said drastic cuts in doctors' hours of training imposed by the European Union were a cause of "grave concern".

British doctors following the career path to consultant have been restricted to a maximum of 58 hours work a week since August 2004 under the European working time directive, and further restrictions are due to bring the UK working week down to 48 hours by 2009. Calling for Mr Blair to negotiate an opt-out from the legislation for surgeons, Mr Ribeiro said surveys by the college had revealed "very disturbing consequences" of the cut in hours. Three-quarters of specialist registrars - the most senior trainees - said continuity of care had worsened and half said the quality of care had been affected.

"Undue emphasis on working hours that disrupt continuity of care could harm, rather than improve, patient care. It can also compromise patient safety," he wrote. "Training for the management of emergencies can only be provided when they arise, often irregularly and out of hours." Hours of work for doctors were cut over a decade ago because of fears that fatigue was putting patients at risk. But calculations have shown that the average time spent in training by surgeons before becoming consultants has come down from 30,000 hours in the early 1990s to 8,000 hours and is set to fall to 6,000 hours.

A review of the change published in the British Medical Journal last year said that many surgeons were taking up consultant posts without basic skills. "To become a competent surgeon in one fifth of the time once needed either requires genius, intensive practice, or lower standards. We are not geniuses," the authors of the review said.