WRITTEN QUESTION E-2285/02

by Antonios Trakatellis (PPE-DE) to the Commission

(25 July 2002)

Subject: Refusal to pay overtime and consequences for the health care of citizens and doctors' health resulting from cuts in the numbers of doctors on duty

According to a reference document submitted to the European Parliament and in the light of many related incidents that have occurred on Greek territory, it seems that unexpected cuts are being made in the number of doctors on duty and that duty doctors are not being remunerated for their work. This has occurred, for example, in the

region of Chalkidiki. Since Chalkidiki is much frequented by tourists, especially in the summer, and given that the nearest hospital to the region is in Thessaloniki which is some 60 kilometres away, the conditions of care for patients are naturally particularly poor. This situation is completely at odds with Article 141, paragraph 2(b) of the EC Treaty which states that pay for work at time rates shall be the same for the same job, something which does not of course occur in the above instances, since doctors work overtime for which they are not remunerated. Likewise, the basic social rights of workers which are protected by the Community Charter of the Fundamental Social Rights of Workers and the Council resolution on fundamental policy options in the health sector are being violated, since they are performing compulsory work for which they are not receiving any remuneration.

In view of all the above and also the lack of interest shown by the Greek Government in finding a solution to the problem, will the Commission say:

1. Will it take measures to put an end to the violation of the basic social right of workers to receive equal pay for equal work and thus ensure that overtime worked by doctors is remunerated?

2. What action can the Commission take to intervene to ensure the proper care of European citizens and to ensure that doctors in the Greek national health system enjoy dignified working conditions?

3. What measures does the Commission intend to take to put an end to the above cuts which seriously endanger the health of citizens and the care they receive?

4. How does it intend to address the fact that doctors' very health is at risk and that there is a danger that medical errors may occur, since doctors are exhausted by examining patients uninterruptedly and without the assistance of nursing staff?

Answer given by Mrs Diamantopoulou on behalf of the Commission

(20 September 2002)

The question asked by the Honourable Member touches on two different issues. The first is overtime remuneration for doctors on call, the second the protection of their health and safety.

As far as overtime remuneration is concerned, it remains an area of national competence and thus does not fall within the scope of Union law. The Commission would point out that Article 137(6) of the EC Treaty excludes remuneration from the areas in which the Community shall support and complement the activities of the Member States, while Article 141(2)(b) of the EC Treaty covers equal pay for male and female workers and thus does not apply in the present case.

As far as the protection of health and safety is concerned, the provisions of the Working Time Directive (Council Directive 93/104/EC of 23 November 1993 concerning certain aspects of the organisation of working time(1)), in principle, apply. According to Article 1(3), only the activities of doctors in training come within the exceptions to the scope of that Directive(2).

Workers covered by the Directive are entitled to:

- a minimum daily rest period of 11 consecutive hours per 24-hour period (Article 3);

- a rest break where the working day is longer than six hours (Article 4);

- an uninterrupted rest period of 24 hours for each seven-day period (Article 5);

- an average working time for each seven-day period, including overtime, not exceeding 48 hours (Article 6);

- paid annual leave of at least four weeks (Article 7);

- a limit on the length of night work to an average of eight hours in any 24-hour period (Article 8).

Directive 93/104/EC provides a number of derogations from its basic rules, having regard to particular features of certain activities. Article 17, paragraph 2.1 (c) (i) lays down that Member States may derogate from Articles 3, 4, 5, 8 and 16 in the case of activities involving the need for continuity of service or production, particularly services relating to the reception, treatment and/or care provided by hospitals or similar establishments, residential institutions and prisons.

Concerning the working time of doctors, the European Court of Justice held that time spent on call in primary health care teams must be regarded in its entirety as working time, and where appropriate as overtime, within the meaning of Directive 93/104/EC if they are required to be at the health centre. If they must merely be contactable at all times when on call, only time linked to the actual provision of primary health care services must be regarded as working time (Case C-303/98 SIMAP(3)).

It is the responsibility of the Member States to ensure compliance with these provisions and to sanction any breaches thereof.

(1) OJ L 307, 13.12.1993.

(2) Doctors in training are covered by Directive 2000/34/EC of the Parliament and of the Council of 22 June 2000 which amends Council Directive 93/104/EC (OJ L 195, 1.8.2000) and has to be transposed by Member States not later than 1 August 2004.

(3) Case C-303/98, ECR 2000, p. I-07963.