In the long-running debate over public hospital doctors' working conditions, it remains unclear which is more important - endurance or rest. Devotion to duty wins public respect, but at some point it must give way to the need for proper rest if quality of patient care is not to be put at risk. Health secretary Dr York Chow Yat-ngok probably spoke for the 'old school' recently when he called public doctors petty minded for wanting standard working hours. Patients often needed round-the-clock care and many 'professional' doctors would not care what time they went off duty. Now the new head of surgery at the University of Hong Kong, Professor Lo Chung-mau, says a Hospital Authority move to cap working hours at 65 a week is damaging surgical training, with trainees doing fewer operations and even leaving in the middle of operations because of the cap on working hours. Meanwhile the surgical department was accumulating a liability for doctors' days off without any compensatory manpower, meaning service capacity was falling. 'Once [doctors] take up medicine, they should be prepared for the hardships,' he said. 'I worry that our new generation of doctors will not have enough skills and experience.' We should be thankful for the devotion of senior doctors like Lo who resist the temptations of the private sector. But there is a real issue here of medical staff shortages, because so many do defect. Claims that as a result public doctors have worked up to 100 hours a week and 24 hours in one shift raise a public interest issue of patient care and safety. The government has introduced a HK$172 million package to address the record high turnover of medical staff in public hospitals, and doctors have launched a lawsuit against the Hospital Authority for better working conditions, such as standard working hours as a basis for working out compensation for overtime. Ultimately health reforms, including voluntary insurance that shift more of the burden for primary care to the private sector, will help relieve the pressure. But the two sides will still have to strike a work-life balance tilted towards patients, but not too heavily against their doctors.