Here are my two favourite bureaucracy quotes. The
first is by Thomas Sowell, an American writer and
economist of sorts. It runs thus: “You will never
understand bureaucracies until you understand that
for bureaucrats procedure is everything and outcomes
are nothing.” The second quote is from another
American writer and commentator, Mary McCarthy:
“Bureaucracy, the rule of no one, has become the
modern form of despotism”.
Nothing describes these quotes better than the huge
bureaucracy created by the European Commission (EC)
in Brussels. Headed by the President and 26 other
commissioners, the EC has over 25,000 full time
employees, who are split into departments called
Directorates-General and Services. This excludes the
10,000-odd ‘external staff’ — consultants,
contractual agents and national ‘experts’ — who are
on the payroll, many for one assignment after the
other. The largest single DG is the
Directorate-General for Translation with a staff of
over 2,200 which translates countless reams of paper
into the various languages of the member countries.
This vast bureaucracy, centred in Brussels and
spread across Europe and every major national
capital of the world, routinely produces enough
paper to destroy forests (example: well over 2,000
press releases a year translated in different
languages) and also shackles basic sanity. If you
thought our bureaucracy is the worst, think again.
There is little to beat the babus of Brussels.
The European Working Time Directive (EWTD) states
that any worker is entitled to a rest period of no
less than 11 consecutive hours in each 24-hour
period during which he works for the employer. Thus,
no work-shift can be longer than 13 hours. Fair
enough. Now consider the latest example of
bureaucratic absurdity — one that would make all
trade unionists proud. The European Commission has
ruled that from 1 August 2009, no junior doctor in
any European Union member state can work more than
48 hours per week; they must have two rest periods
of at least 24 hours in every fortnight, plus four
weeks of annual leave. In addition, two judgments of
the European Court of Justice have clearly stated
that if a junior doctor on call in hospital, but
happens to be resting in bed, she or he will still
be considered to be working. Hospitals face stiff
penalties if this rule is broken. And this rule
comes into effect when swine flu is raging across
Europe, especially the UK.
Read the two directives together, and
it is obvious how this ridiculous ruling will have
disastrous consequences. Assuming a 12-hour shift,
from 1 August no junior doctor will be allowed to
work more than four days per week. No country in
Europe has enough junior doctors to ensure that its
hospitals will have a fully staffed rota on a 24/7
basis and still adhere to nobody being allowed to
work more than four days per week. Even when the EC
had the rule of 56 hours per week, member countries
disregarded it for the want of sufficient doctors. A
list compiled by Professor Roy Pounder of the Royal
College of Physicians in London shows that 17 of the
27 member states led by France and Germany have
openly said that its doctors will have to work more
than 48 hours week to keep their hospitals going. I
suspect that the remaining 10 stated 48 hours or
less so as to avoid needless attention from
Brussels.
Implementing such a rule will have disastrous
consequences for health care. For one, there just
won’t be enough junior doctors per shift. For
another, patients will have to see keep seeing ‘new’
doctors who often won’t understand their problems.
As Professor Pounder put it, clinical care will
suffer as each new doctor has to re-learn a
patient’s problems; will neither see the evolution
of an illness — a vital educational experience for
any junior doctor — nor appreciate the subtle
changes in a patient’s condition from day to day.
Since the average stay for an acute medical
admission in the UK is 7 days, multiple handovers
will now be inevitable, to the detriment of patient
care.
Dr John Black, the president of the Royal College of
Surgeons, has been more blunt. He has warned of an
impending catastrophe in the British National Health
Service with the coming of the 48-hour working week.
According to him, Britain will face an acute
shortage of surgeons, leading to operations being
cancelled and wards closed down.
Who thought of this absurd rule? The babus of
Brussels. Were they doctors, and did they know
anything of how hospitals are run? Absolutely not.
Why then the rule? Because if truckers, stewardesses
and pilots cannot work for more than hours a week
with a minimum rest period of 11 hours in each 24
hours, then so should doctors. Three cheers for
Brussels! May it bring more jobs for Asian doctors!
Published: Business World, August 2009
