Reports suggest that Jeremy Corbyn’s Labour Party is proposing a four-day working week
When I read the reports that Jeremy Corbyn‘s Labour Party is proposing a four-day working week, I could not believe any supposedly serious politician was contemplating something so fundamentally stupid.
Yes, I can see it might buy Labour some cheap votes at the ballot box, especially from those won over by the economically illiterate, but electorally compelling, footnote — that a shorter week (32 hours) would involve no loss of pay.
But this completely ignores the fact that reducing the hours of public-sector employees — doctors, nurses, teachers, firefighters, police officers, etc — would impose an extra cost on the Treasury, because the workforce would have to expand to ensure productivity and service delivery.
According to the Centre for Policy Studies, the best-case scenario would be a £17 billion hit, rising to £45 billion if there was no increase in productivity.
Which is all bad enough. But what Corbyn and his Shadow Chancellor, John McDonnell, are choosing to ignore is that this proposal would spell the end of the NHS as we know it. That’s the same NHS the Labour Party is supposed to love and cherish. The same NHS that Mr Corbyn insists — over and over — won’t be safe in Tory hands.
Well, you might — just might — be able to produce enough widgets of the appropriate standard in a four-day week, but you certainly can’t produce good doctors or nurses, or deliver first-class healthcare.
I have worked in the NHS for more than 40 years, and I can tell Mr Corbyn that his radical plan would be a catastrophe.
How can I be so confident? Because we’ve already had a disastrous dress rehearsal for a four-day working week in the shape of four words that strike dread into hard-working hospital doctors throughout Britain: the European Working Time Directive (EWTD).
Mr Corbyn and his Shadow Chancellor, John McDonnell (pictured), seem to be overlooking the fact that their new proposal would spell the end of the NHS as we know it
Introduced here in the late- Nineties, it seemed a benign and well-intended idea. A right to four weeks’ holiday a year, rest of 11 consecutive hours in every 24, restrictions on excessive night work and, best known of all, a maximum working week of just 48 hours.
Right from the start, I and many of my clinical colleagues could see it would be a disaster for the NHS. I vigorously campaigned against it at the time, but the EWTD was introduced, and it is no exaggeration to say that, two decades later, it has brought the NHS to its knees.
Let me explain why. I was a junior doctor back in the Seventies, when we used to work around the clock. Five long days a week was just the start, with every other night and every other weekend thrown in for good measure.
The NHS is already in crisis — from a shortfall of 6,000 full-time GP posts and 40,000 nursing vacancies around the country, to the 43 per cent of consultant posts that last year went unfilled
We would often work 80-hour weeks, sometimes even 100 hours or more. I will concede that such marathon stints were excessive and could be potentially dangerous, but the quality of training they offered to ambitious, hard-working young doctors was exemplary.
This was where our real learning — our serious, hands-on clinical experience — started, seeing patient after patient and trying to make as many of them better as we could.
The EWTD made that sort of intense training impossible, and it also damaged something absolutely vital to any hospital department: a sense of shared team spirit. Firm culture, we call it.
When everyone is working flat out, covering for others when they can, apologising when they can’t, an important sense of shared purpose and of driving forward together emerges.
It’s what makes a successful medical team — something all clinical staff want to be part of.
But that all went with the EWTD. Working weeks were cut, rotas rejigged, staff moved around endlessly, with a growing demand for locum cover rewarded at ridiculous rates. Not to mention an absence of continuity of care for patients.
It’s counter-intuitive, but, by limiting the hours a doctor can work, we have made the NHS a less happy, less fulfilling and infinitely more stressful place to work for all staff.
It’s one of the main reasons the NHS — despite still being staffed by brilliant, dedicated, hard-working doctors and nurses — is in a mess.
Yes, it’s under-resourced and, as the party election manifestos will doubtless show, deeply misunderstood by politicians. But the EWTD is a major factor in under-staffing and the chronic inability of the NHS to cope with ever-rising demands.
The tragedy is that it didn’t have to be like that. We didn’t have to blithely introduce every last syllable of the EWTD to the NHS.
We should have done what the French health service did: give a Gallic shrug and introduce it in name only, along with a requirement that all doctors should be engaged in an additional 12 hours of post-graduate training every week.
Problem solved. Suddenly, French doctors were working efficient and effective 60-hour weeks, while ours were stuck on 48.
I was reminded of this pragmatic approach when I engaged in a similar sort of battle on something called the European Clinical Trials Directive. In essence, it made the cost of trialling new drugs so expensive that only the established big pharmaceutical companies can finance them. And then charge eye-watering prices for the end result.
‘Why aren’t you angrier about all these new European rules?’ I asked an Italian colleague at a conference.
He looked at me blankly, before realising what I was talking about. ‘Oh, those rules — we call them the English rules because only the English are stupid enough to obey them.’
And he’s right. We were stupid enough to introduce the EWTD and then follow it to the letter, something that two former presidents of the Royal College of Surgeons have since described as ‘the biggest disaster ever imposed on the NHS’. To which I would merely add the words ‘so far’. Because if the EWTD has been bad for the NHS, then Corbyn’s idea of a four-day working week really could be the final nail in its coffin.
The NHS is already in crisis — from a shortfall of 6,000 full-time GP posts and 40,000 nursing vacancies around the country, to the 43 per cent of consultant posts that last year went unfilled.
Thirty years ago, there would have been six or seven highly qualified doctors competing for every consultant position. Now, there just aren’t enough.
And if Labour’s four-day working week was introduced, we would need even more consultants — another 20 per cent, in fact.
If Mr Corbyn is serious about reviving the NHS, he has to understand it first — something that has proved beyond every health minister, every prime minister, throughout my long working career.
And, first of all, he should look at the damage done to the NHS by the EWTD and learn from it.
The EWTD was never designed for a non profit-making organisation such as the NHS — and nor is Mr Corbyn’s pipe dream of a four-day working week.
Taxpayers, who are already funding the NHS to the tune of £150 billion a year, simply won’t buy the absurd notion that doctors and nurses should suddenly start working four-day weeks while still being paid for five.
Nurses can already work four-day weeks if they want. My own senior nurse does exactly that.
But doctors — particularly the young, ambitious doctors on which the future of our NHS depends — have to be allowed and encouraged to put in the hours they need to do the job well and to train.
This will lead to doctors who are not just better, but happier, with more efficient medical departments and, eventually, a better service for patients.
Politicians from all parties would do well to remember that before it really is too late.
- Professor Dalgleish is a professor of oncology at St George’s, University of London.