Abstract
It was perhaps fortuitously apposite that John Ashton’s article 1 on the four-day working week should appear in the same edition as Terence English’s letter 2 regarding reduced NHS working hours. I have been retired for nearly 20 years now and my maximum-part-time contract added up to an average 60-h week when on-call was included. It was still possible to include some private practice in my ‘spare time’. This was mirrored in other occupations, such as nurses and firemen, and even junior doctors who can take on second jobs out of hours as locums.
There is a shortage of staff at all levels. Trainees are expected, when on-call, to cover large parts of hospitals, sometimes outside their level of expertise. If more doctors work part-time, more will have to be trained, which has a cost implication. For those specialties where there is an ethical, if not a contractual, obligation for continuing patient care, a four-day week is perhaps unacceptable.
There may be a case for a reduced workload before retirement. For some older doctors, on-call duties with sleep deprivation become more difficult and perhaps potentially dangerous. I myself retired at 60, started my pension and returned to five sessions with no on-call for a further two years. Incidentally, my hospital advertised for a 5-session Consultant post to job-share with me. Nobody applied.