Nurses are not allowed to take the place of a doctor when it comes to the extended hours, so that may be a possible reason. However staff will still need to be working; 2 receptionists at the least from a health and safety aspect. Doctors may also require a female chaperone, so this could be a nurse or HCA. I agree about negotiation on pay rates but quite often this proves futile, and the wording used in contracts is brought in to play in such a way as to make any attempts at negotiating unsocial hours rates difficult to achieve..
As far as the EU working directive goes this seems to be very 'flexible' when it comes to the hours doctors work for the OOH service providers. It is not unusual fo the same doctor to be on shift for 24 hours and sometimes more; how are they allowed to get away with this when all other staff (nurses, drivers, call handlers, etc.) are not? Many expect to be able to get some rest and leave the call triaging to nurses - yet still get their full hourly rate of pay! But that is another topic for discussion I think.
Opinions are just that - they are not the same for each individual, although some may be of the same mind. Martin :o)