Elspeth Isbister Aberdeen

Preregistration house officers (PRHOs) are pressured to lie about their hours of work during periods of monitoring by management. This is one of the issues being taken up by the BMA Junior Doctors Committee in its "fair treatment" campaign for junior doctors, which was launched this month.

Dr Trevor Pickersgill, chairman of the committee, said, "Junior doctors are still working too many hours despite tougher measures to regulate their hours of work. No junior doctor should have to tolerate coercion or unfair treatment in the workplace. Junior doctors do not find it easy to seek help. They risk putting their careers on the line if they are seen to rock the boat."

Under the "new deal," there are statutory limits to the maximum number of hours a PRHO may work. If a hospital trust fails this requirement, then the PRHO posts found to be non-compliant are removed from the PRHO matching scheme until the department or trust alters the rota to make that post compliant. Recent figures from the Scottish Executive, however, show that 55% of all Scottish junior doctors are still working more hours than was agreed in the new deal contract.

To enable trusts to keep their valuable PRHO posts, some junior doctors feel they have been coerced into falsifying their paperwork: trusts seemed to meet their targets and face a lower salary bill, at the expense of the salaries of junior doctors.

A sample of Scottish PRHOs, who wish to remain anonymous, said they "felt pressured" by their consultants to lie about the hours they worked, in order to receive good references. Others felt a conflict when consultants asked them not to lie about their hours of work, yet simultaneously asked them to consider the possibility that if they did not, the department stood to lose valuable PRHO posts for the coming year.

Conversely, some junior doctors, such as Dr Suzanne Lawfer from Aberdeen, lied because they felt that they should be working over and above the hours stated in the new deal contract. They argued that they were being educationally penalised by the new regulations as they were not receiving adequate "hands on" experience, and there was no provision for "following patients through their hospital stay."

One PRHO commented that if things stay as they are, the trust will have to develop a two year PRHO programme so junior doctors have sufficient experience to progress to the grade of SHO.

Dr Catriona MacGregor agrees with hospital consultants about a developing "lack
of patient continuity" and decreased teamwork among departments. Many juniors said this was due to the awkward shifts and staff anonymity that the new rota system created.

Dr James Mclay, a consultant physician at Aberdeen Royal Infirmary, said he specifically asked his PRHOs not to lie about their hours of work. He says "I have heard rumours
of some consultants standing over their PRHOs whilst they were filling in their time keeping forms."

Whilst he believes in the ethos of the New Deal, Dr Mclay feels that the implementation of the New Deal was "rushed", without thought to the repercussions that it would bring.

He believes the new rota system is leading to a decrease in the quality of patient care. He acknowledges that this is very stressful for the new PRHOs, "it is reducing my PRHOs to tears, it's taking good doctors and destroying them, that is wrong."