Physicians and nurses at a national hospital in Osaka are allowed to rack up a whopping 300 hours of overtime per month under a labor-management agreement, according to documents obtained by a lawyer.

The limit is three times the government-recognized high-risk threshold of death from overwork.

Under the agreement signed by the hospital and a workers’ representative, around 700 doctors and nurses at the National Cerebral and Cardiovascular Center Hospital in the city of Suita, Osaka Prefecture, are eligible to work up to 300 extra hours a month and 2070 hours of overtime per year.

The hospital said the cap was set at such a high level due to the nature of work that includes treating emergency patients.

Despite the figure, no staff members have worked for more than 100 extra hours per month in the past year, a spokesman told The Japan Times on Thursday. “It has been around 50 or 60 hours per month at the maximum,” he said.

But given the government’s recent policy efforts to reduce excessive overtime, he said the hospital is planning to review the agreement.

“I’ve never seen a labor management agreement allowing up to 300 hours per month of overtime,” said Tadashi Matsumaru, a lawyer who requested the document’s disclosure via the labor bureau.

At other hospitals, such agreements usually set limits of around 100 hours per month, he said, adding that such punishing working conditions for physicians must be changed immediately.

“The current way physicians work is damaging their health. At the same time, there is this view that without it, the nation’s health care system cannot be sustained,” Matsumaru told The Japan Times. “This is a pressing issue that needs to be addressed.”

As part of efforts aimed at reforming the long-standing culture of overwork, the government plans to revise the Labor Standard Law to limit monthly overtime to 100 hours for the first time.

Doctors, however, would be left out of the new regulation for the first five years after it takes effect because of the nature of the profession — namely that they should, in principle, treat patients when requested.

“Even if there are such special characteristics of the profession, they are humans like any other workers,” Matsumaru said. “Doctors can provide good health care only if they can work under ordinary labor conditions.”

According to the health ministry, 41.8 percent of hospital doctors worked more than 60 hours per week in 2012, the highest among all occupations.

In recent months, two suicides of medical trainees were recognized as karōshi (death from overwork), including the case of a male obstetrics and gynecology resident who killed himself in 2015 after his monthly overtime exceeded 200 hours.

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