About duty hours of resident doctors

As per the directives of the Honourable Supreme Court in its judgment dated,25.9.87, in writ petition No. 348-352 of 1985, all the State Governments, Medical Institutions and Universities are required to amend their rules and regulations to introduce a uniform residency scheme by 1993 “A uniform practice has to be evolved so that the discipline would be introduced. We accordingly allow the present arrangement to continue for a period of five yearsI.e. upto 1992 inclusive. For admission beginning from 1993 there would be only onepattern. All Universities and institutions shall take timely steps to bring about such amendments as may be necessary to bring statutes, regulations, and rules obtaining in their respective institutions in accord with this direction before the end of 1991 so that there may be no scope for raising of any dispute in regard to the matter.The uniform pattern has to be implemented for 1993. It is proper that one uniform system is brought into vogue throughout the country.” In this connection Ministry of Health & Family Welfare, Govt. of India has sent directive to all states & U.T. administrations vide letter No. S-11014 /3/91/ME (P) dated 05 June, 1992. Unfortunately many States in India refused to obey that orders till date. Ministry of health and family welfare, Government of India sent consolidated instructions to all states and UT administration vide letter number S-11014 /3/91 ME(P) regarding implementation of Uniform Central Residency Scheme after the directives of the Supreme Court in its judgment dt. 25.9.87 in writ petition No. 348-352 of 1985, The instruction No.13 of this letter ‘Hours of Work’, it is mentioned that “Continuous active duty for resident doctors will not normally exceed 12 hours per day. Subject to exigencies of work the resident doctors will be allowed one weekly holiday by rotation. The resident doctors will also require to be on call duty not exceeding 12 hours at a time. The junior Residents should ordinarily work for 48 hours per week and not more than 12 hours at a stretch subject to the condition that the working hours will be flexible as may be decided by the Medical Superintendents concerned keeping in view the workload and availability of doctors for clinical work.” As we see, here total weekly hours of work (48 hrs/week) as well as the maximum hours in single stretch (12 hours) are clearly defined. Of course the authorities may remind us the flexibility given in above instruction. However we would like to state the following. a) Any flexibility given by law or constitution should only be used as a special measure and must not be used as ROUTINE. Today Medical colleges in India are forcing Junior doctors to work continuous 24 Hrs (!) and this is being practised routinely for last many years. b) That flexibility is given for ‘Working hours’ & not for hours of work that is, while authorities are free to post any doctor in day or night or in holidays, they must stick to the norms of “hours of work” that is Maximum 48 hours in a week and 12 hours Finally even if the total no. of doctors posted (when all posts are filled) are not able to cope with work load under normal working-hours-limit then the no. of post must be increased. In no case junior doctors to be forced to work more than what is permitted by law and various recommendations. in a single stretch. The International Labour Organization, Geneva (India being the member of the same) as early as in 1962 in its recommendation No.116 concerning Reduction of hours of work in its General principle No. 4 states as PRINCIPLE 4: Normal hours of works should be progressively reduced, when appropriate with a view to attaining the social standard indicated in the Preamble of this recommendation without reduction in the wages of the workers as at the time hours of work are reduced. PRINCIPLE 6 states as - Where normal weekly hours of work are EITHER FORTY EIGHT OR LESS, MEASURES FOR THE PROGRESSIVE REDUCTION OF HOURS OF WORK in acc