Some doctors on strike had just worked 28-hour shifts

Seamus Enright

Hundreds of patients in the Cavan-Monaghan hospital region were affected on Monday when non-consultant hospital doctors (NCHD) took part in a day-long strike action calling for an end of 24 hour work shifts as required by European law.
The first such national strike in almost 25 years, patients attending Cavan General Hospital were yesterday greeted by junior doctors at the main entrance carrying placards and posters emblazoned with the words ‘24 No More’. Some NCHDs told The Anglo-Celt that they had just come off working a 28-hour shift, while others were due to go back on-call once the industrial action ended at midnight on Tuesday.
“We never wanted it to come to this,” Dr Rukshan Goonewardena told the Celt. “We didn’t want industrial action, we tried to negotiate with the HSE to prevent it but unfortunately it came to a point where not enough was being done and we had to make this tough decision.”
He said the main cause of the action was down to concern for both patient safety and doctor welfare. Despite the strike action emergency care, cancer care and dialysis care continued. While emergency wards were open, people were being told to expect delays due to the staff shortages. “We don’t feel that doctors who work 36 hours, sometimes without enough sleep, are safe enough to treat patients. The HSE should acknowledge this. Another [reason to strike] is for adequate time rest between shifts.”

HSE between rock and a hard place
The Irish Medical Organisation (IMO) backed ‘24 No More’ campaign, which developed across social media networks in recent months and reportedly owes its roots to tragic events at two national hospitals in Cork and Tallaght last year. Following the deaths of two doctors, support services warned such incidents and the highly pressurised circumstances in which they occurred were not isolated incidents, and urged medics to seek help. Dr Goonewardena recognises the HSE are between a rock and a hard place on the matter, but says regardless, a balance must be struck. “We know how tough it is. On the one hand they have the treatment of thousands of patients on a daily basis to consider, and on the other there aren’t enough doctors in the country and hospitals. But we really need to come up with a plan and reach an agreement on fair working hours.”
Despite lengthy discussions at the Labour Relations Commission and a set of proposals from HSE management, agreement has not yet been reached. The IMO has since refused to return to the LRC talks believing the HSE proposals lack credibility, and say they want also sanctions imposed on the hospitals which insist upon these working hours.
At present junior doctors can begin at 9am on any given work-day and be on-call onsite until 1pm the next day. A similar situation affects members working in medical and surgical departments.
It’s a move which has raised fears that the dispute could escalate to another scheduled 48-hour action next week unless a resolution is found.
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Another junior doctor, David Doran is hopeful further industrial action won’t be the case, but an agreement has to be put in place, and sooner rather than later.

Action now
“We appreciate there is the need for long hours in some cases to facilitate training and the implementation of the European Working Time Direction is probably a long term goal, but we at least have to have an agreement that steps towards that will be made,” said Dr Doran.
The stress, enormous workload and pressure which face doctors in Cork and Tallaght, are a country wide concern.
“There is an element of failing to speak out, mainly due to the responsibility doctors feel towards the patients, to colleagues as well. It is very difficult to walk away from your post, to leave patients behind. This is a huge step for us to come out on strike, we know and we are inconveniencing patients by doing this, but its a step that had to be taken, for patients and junior doctor’s alike.”
One member of the public who The Anglo-Celt spoke with, and asked not to be named, said she was fully behind the action taken by the junior doctors.
There with her husband who was attending the hospital for an appointment, she said they knew about the strike action before coming to the hospital, and though it caused inconvenience, she understood its motives.
“I wouldn’t want a doctor who has been on his feet for over 24 hours looking after me, you wouldn’t get it anywhere else. It’s an awful amount of pressure, you hear the government and the HSE are stuck for money, surely there has to be a better way of doing things than working doctors to the bone.”
The HSE meanwhile have said they will re-schedule appointments, but if further strike action goes ahead, then there will be problems as there will be a backlog of appointments.
Cavan General Hospital has had to defer certain elective surgeries and outpatient’s appointments. The hospital has been in touch with patients directly in recent days regarding cancellations. These patient’s appointments will be rescheduled as soon as possible.