Some doctors still work very long hours

The British Medical Association research found staff and associate specialist (SAS) doctors work an average of 73 hours a week.

Under the European Working Time Directive they should not work more than 48 hours a week.

There are around 12,500 SAS doctors in the NHS. They are fully trained, but not at consultant level.

Patients do not want to be treated by tired, demoralised overworked doctors, whatever their grade. Mr Mohib Khan

They include associate specialists, staff grade doctors and dentists, clinical assistants and practitioners in non-standard posts.

There is concern that these doctors are being forced to take on new work because of new rules limiting junior doctors' hours to 58 a week.

Earlier this year the BMA's annual conference heard that SAS doctors were not being used to their full potential and were prevented from climbing the career ladder.

Although SAS doctors should be protected by law from working excessive hours, a BMA spokesman said there was evidence to suggest that they were particularly vulnerable to bullying, and often intimidated into not asserting their rights. Many qualified overseas.

Over 2,500 doctors were surveyed. Half said they were suffering from low morale and most were less happy than they were five years ago.

Around one in five was considering retirement in the next five years. If this trend is applied nationally, it represents a loss of 2,500 doctors to the NHS.

Patient care threat

Mr Mohib Khan, chairman of the BMA's Staff and Associate Specialist Committee, warned patient care could be compromised if morale continues to fall.

He said: "It is important that trusts are not allowed to use staff and associate specialist doctors as the easy way of dealing with changes to junior doctors' hours.

"Patients do not want to be treated by tired, demoralised overworked doctors, whatever their grade.

"I am particularly concerned with the decline in morale over the last five-years and the fact that so many staff and associate specialist doctors are working excessive hours."

The survey found:

• One in two SAS doctors surveyed says their morale is low or very low.

• Six in ten respondents report their morale having decreased in the last five years.

• Doctors are contracted to work a weekly average of 44 hours but in reality the average full time SAS doctor works 73 hours per week.

• Three in four favour a complete revision of the SAS grades contracts.

• Nine in ten respondents believe there needs to be better pathways to career progression for SAS doctors.

• Nine in ten think pay should be more strongly aligned to the NHS consultants' salary.

  An SAS doctor earns around �60,000, compared to top consultant pay of �85,000.

Mr Khan said: "This survey gives us the clear picture of grass roots opinion. SAS doctors are telling us they want a new contract that delivers increased opportunities for career progression and recognises and rewards their skills and experience."

The BMA is about to enter negotiations with the NHS Confederation about a new contract for SAS doctors.

An NHS Confederation spokesman told BBC News Online: "It is widely recognised that the position of SAS doctors has to be reviewed, and that is why we have already started considering the issues which are highlighted by this survey.

"The Government paper "Choice and Opportunity" set out a range of options for improving the position of this valued group of doctors, and the NHS Confederation is now looking at the scope of these negotiations."