NHS 'not ready' for doctor hours

The directive comes into force in August

The National Health Service is not prepared for changes to doctors' working hours, the Tories say.

Speaking in a Commons debate on Wednesday, Tory Andrew Lansley said Labour was complacent about the impact of the European Working Time Directive.

While the government had estimated it would cost up to £780m to implement, it had provided only £46m over three years for specific action, Mr Lansley said.

Health Minister John Hutton dismissed Tory claims as "without foundation".

The directive concerns junior doctors' hours and the out-of-hours part of the new GP contract.

'Complacency'

Mr Lansley said: "The GP out of hours service looks like it will cost nearly double what it has cost up to now.

"But most PCTs (Primary Care Trusts) are going to get only about 60 or 70% of that additional cost and many of them cannot afford that additional cost."

Our priority is to implement the directive in a way which maintains both the quality and the accessibility of NHS services John Hutton Health Minister

He said: "The government amendment - complacency is written through it like sugar through a stick of rock."

He listed issues that the government had not mentioned in its amendment to the directive, including "the impossibility of compliance by August 2004 and the need for urgent interim action as recommended by the House of Lords".

He said there was "no reference to the things that the government have found too difficult".

Mr Lansley said his party supported the reduction of junior doctors' hours to levels consistent with patients' safety but added that this could be better done without the European directive.

"Without foundation"

He accused the government of a complacent reaction to two European Court of Justice judgments, one concerning primary care doctors in Spain and the other about doctors in Germany.

Health Minister John Hutton said Tories' fears over GPs' out-of-hours services were "completely without foundation".

He said the directive was "crucial" to "ensuring frontline staff work reasonable hours and have proper rest periods".

However, he acknowledged that its present form, together with the recent rulings, would make the task of running the NHS "immeasurably more difficult".

He said implementing the directive "presents a very considerable challenge to the NHS and in particular to specialities such as paediatrics and obstetrics" but insisted the government would not implement it by reducing services.

Concerns

"Our priority is to implement the directive in a way which maintains both the quality and the accessibility of NHS services," he said.

Mr Hutton said all EU member states and accession countries, with the exception of Greece and Lithuania, had "expressed concerns" over the European Court's rulings on the directive and had supported a review of some of its aspects.

The European Commission has agreed that the directive needs to be amended and proposals would be brought forward before the summer, he said.

He said there has already been "a very substantial fall" in the hours that junior doctors worked, with 95% working 56 hours or fewer, which is less than the 58 hours specified in the directive.