Editor—Last week Mr Gary Hart was sentenced to five years' imprisonment for causing the Selby rail crash and the deaths of 10 people by dangerous driving after falling asleep at the wheel. A tragic chain of events led to the deaths of 10 people and injury of more than 70 people when Mr Hart fell asleep while driving his Land Rover, causing it to veer off the M62 and on to a railway. The prosecution provided evidence that Mr Hart had had no sleep the previous night, which had led to impairment in his ability to drive. At the trial the judge, Mr Justice Mackay, warned: “The sentence of the court will be a sentence of immediate imprisonment of a substantial term and disqualification of a longer term.” Indeed, people have been campaigning to make driving while tired as socially unacceptable as drink-driving.
We have great sympathy for those who died in this tragic crash and for their relatives, but we would like to highlight the problems of sleep deprivation facing many doctors. For example, we as trainee orthopaedic surgeons still work band 3 on-call contracts and frequently work more than 72 hours a week, often with little or no sleep during a 32 or 56 hour shift. After such shifts we both have to drive home by motorway, often falling asleep quickly once home.
We do not want to enter the political debate about working hours and practice, but we suspect that many doctors are uneasy about driving after a busy on-call shift. Strict guidelines about rest periods for driving or flying are enforced for haulage drivers and pilots, and concerns have been raised about the legal considerations of sleep deprivation in doctors.1 Sleep deprivation is known to have a detrimental effect on cognition, decision making, and driving ability.2–4
We are told by sources within the BMA that around 3500 junior surgical trainees in England and Wales are still working band 3 contracts (J Cross, Junior Doctors Committee, personal communication). We are particularly concerned about the legal implications of surgical trainees driving home after a busy on-call shift. If the law judges us unfit to drive in this state, what are the implications for operating?
References
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