Shorter hours are harmful to patients
A 48 hour week was supposed to make hospitals a safer place for patients, but most surgeons think it's had the opposite effect. The European Working Time Directive was fully enforced more than three months ago, but a Royal College of Surgeons survey found that 64% of surgeons think that patient care is worse. More than 360 consultant surgeons and more than 500 trainees responded to the survey. The college says that services are held together by a "grey market" of doctors who are willing to break restrictions. "Patient care is being made significantly less safe through systems that lead to poor continuity of care, the loss of teams, and 'wildcat' closure of services," said John Black, president of the Royal College of Surgeons.
Baby RB surgery 'not an option'
Doctors want to take the boy off the ventilator that is keeping him alive
A one-year-old boy at the centre of a "right-to-life" legal dispute would not benefit from an operation to help him breathe, the High Court has been told.
The child, known as Baby RB, has a rare, genetic condition that makes it hard for him to breathe independently.
But a leading paediatrician, known as Dr F, said he was "not a candidate" for surgery to try to open up his airway.
Baby RB's father is fighting a hospital's attempt - backed by the mother - to withdraw his life support.
The father's lawyers argue that the boy's brain is unaffected and that he can see, hear, interact and play.
But Dr F, as he is known for legal reasons, told the court Baby RB was living a "burdensome existence".
'On a knife edge'
Baby RB suffers from congenital myasthenic syndrome and has been in hospital since birth.
His father believes he might be taken off his ventilator and returned home if surgeons carried out a tracheotomy, which creates an opening in the neck to deliver air to the lungs.
His doctor has agreed to carry out a tracheotomy assessment on Saturday and report back to the court next week.
My heartfelt feeling is that his existence is impoverished 
Dr F,
Paediatric intensive care consultant
But on Tuesday, Dr F, who is a paediatric intensive care consultant, agreed with the boy's hospital and his mother that his quality of life was so low that it would not be in his best interests to try to save him.
He told Mr Justice McFarlane that Baby RB was living "on a knife edge" and could suffer even greater distress if a tracheotomy was performed and some sort of blockage or infection developed.
He said the boy had no brain-stem function, which was needed to survive independently, and feared he may be suffering but unable to show it.
"He is severely limited in his ability to reach any sort of potential," the doctor said, pointing out that his disabilities would become more and more marked as he grew older.
"My heartfelt feeling is that his existence is impoverished," he added.
'Pitiful existence'
For legal reasons, none of the parties in the court case can be identified.
Both parents, who are in their 20s and are said to be "amicably separated", have been present at the hearings.
The mother agrees with the hospital's lawyers who say her son will lead a "miserable, sad and pitiful existence", even if surgery allows him to be returned home.
Instead, they say they are seeking permission to withdraw fundamental life support "to allow him a peaceful, calm and dignified death".
The hearing will resume on Wednesday.
