Thousands of doctors are working far more hours than European limits allow but feel too frightened to complain, the British Medical Association said yesterday.
Staff and associate specialists doctors on full-time contracts are working on average 73 hours a week, well over the 48-hour working time directive, the BMA said.
Many of them were being forced to accept extra tasks because of phased new rules for junior trainee doctors, for whom a 58-hour maximum came into force on Sunday.
But those on the so-called SAS grades qualified overseas and so provided "easy pickings" for bullies since they did not have support networks of UK-qualified doctors.
The BMA surveyed more than 2,500 of the 12,500 SAS doctors in the NHS. Around one in five was considering retirement in the next five years and half said their morale was low or very low.
The doctors are contracted to work an average 44-hour week, but the BMA said their position in hospital hierarchies mean they have little say in how departments are run.
Mohib Khan, the chairman of the BMA's staff and associate specialist committee, said it was important that NHS trusts were not allowed to use SAS doctors as a way of dealing with changes in junior doctors' hours. "Patients do not want to be treated by tired, demoralised, overtired doctors, whatever their grade."
Nine in 10 of those surveyed want pay aligned more strongly to that of consultants. At present they receive around £60,000 a year, whereas consultants' earnings run into six figures.
Three in four also wanted a complete revision of contracts. The BMA said many such doctors are forced to accept continual changes to their jobs with little or no consultation.
By August 2009 junior doctors will only be compelled to work 48-hour weeks. This week's shift towards that limit has caused serious difficulties for some trusts, although the government insists only "a little handful" have not reached agreement on interim arrangements pending full compliance with the 58-hour limit.
The BMA has pledged legal support where necessary for junior doctors. Hospitals that fail to comply in this area risk £5,000 fines and the new figures on SAS doctors are a clear warning of further action.
· Patient satisfaction surveys across the NHS in England published by the Healthcare Commission yesterday suggested serious shortcomings in mental health services. Fewer than half the 27,000 service users had access to emergency crisis care.
A separate survey of hospital patients suggested an improvement in admission to wards from A&E departments. This year 26% spent more than four hours waiting, compared with 34% in 2002.
