Meeting the requirements of the new deal for junior doctors has proved to be a challenge for the service, particularly in some specialties. The new deal implementation support group is working with trusts to provide assistance and guidance in that area. Junior doctors are currently excluded from the working time regulations but, from August 2004, junior doctors' working hours will be progressively reduced to a maximum of 48 hours a week.
What interest has been taken in the training of junior doctors? What effect will the reduction in hours have and how will services be affected? For example, it is thought that a children's ward in Ayr hospital will have to be closed because it will not have sufficient facilities for the training of junior doctors given the change to their hours. Will that situation spread across Scotland or is it unique to Ayr?
Many issues arise from the implementation of the working time directive, in relation not just to doctors but to other health care staff. We have known about the situation since 1992. It is unfortunate that we made so little progress in the 1990s, but we are catching up and most people believe it a good thing that doctors should not have to work excessive hours.
On the specific question about Ayr hospital, I am aware that there is public engagement with Ayrshire and Arran NHS Board. I pay tribute to the board, because it is not going for the traditional end-stage consultation; it is engaging with the public in a new way at an early stage, in accordance with the Executive's new guidance. That is the correct way of dealing with such complex issues. The board has not made any decisions yet.
Does the minister accept that many trusts are continuing to fail to make junior doctors' posts compliant with the 56-hour rule? That failure puts patient care and safety at risk. Will he state today whether the 50 per cent of newly qualified junior doctors' posts
The posts will not be completely compliant by August. However, the figure to which the member refers is from a few months ago and there has been a great deal of progress since then. We are taking a partnership approach towards the issue and are working closely with the junior doctors committee, which was recently involved in a big event in Edinburgh to drive the matter forward. The issue is complex; it involves service redesign and doing things differently. We are getting there but, as I said, progress was slow in the 1990s. We are catching up but, as my answer indicated, it may take several years to get to the full 48-hour limit.
Does the minister accept that the implementation of the European working time directive, the reduction in junior doctors' hours and the training regime for junior doctors are having a serious and detrimental impact on patient access in my constituency of Greenock and Inverclyde and throughout Scotland? When can we expect a co-ordinated approach from him to that problem in favour of patients?
There is a co-ordinated approach. There is no simple solution. We have been introducing 375 extra junior doctors and that process continues this year. That is part of the solution. We are also in the process of expanding the consultant work force in an unprecedented way. In the partnership agreement, we have set a target of 600—more consultant-delivered care is also part of the solution. The third vital strand is the redesign of services, but that will be done in accordance with the principles of quality and patient safety. Those are the key criteria that will be applied, but we cannot avoid the European working time directive. Ultimately, it is in the interest of patients for junior doctors to work reasonable hours.