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| Cap on junior doctor hours starts | Cap on junior doctor hours starts |
| (about 6 hours later) | |
| European rules preventing trainee doctors from working more than 48 hours a week have come into force. | European rules preventing trainee doctors from working more than 48 hours a week have come into force. |
| Doctors' organisations have criticised the European Working Time Directive, saying the reduced hours means there is too little time to provide training. | Doctors' organisations have criticised the European Working Time Directive, saying the reduced hours means there is too little time to provide training. |
| And there have been concerns it could hamper the NHS response to swine flu. | And there have been concerns it could hamper the NHS response to swine flu. |
| But the government says 97% of the NHS has already met the new requirements, with no effect on training, and plans are in place to cope with swine flu. | But the government says 97% of the NHS has already met the new requirements, with no effect on training, and plans are in place to cope with swine flu. |
| In the mid-1990s, some junior doctors had working weeks which typically topped 100 hours. | In the mid-1990s, some junior doctors had working weeks which typically topped 100 hours. |
| The directive took effect for many other workers in 1998, but the changes to reduce doctors' working hours were incremental and began with consultants. | The directive took effect for many other workers in 1998, but the changes to reduce doctors' working hours were incremental and began with consultants. |
| We fear many junior doctors are being pressured to lie about their hours Dr Andy Thornley, British Medical Association | We fear many junior doctors are being pressured to lie about their hours Dr Andy Thornley, British Medical Association |
| By 2004, junior doctors were included in a 58-hour working week target and by 2007 this was down to a 56-hour week. | By 2004, junior doctors were included in a 58-hour working week target and by 2007 this was down to a 56-hour week. |
| As of 1 August, the target will be 48-hour-weeks for the UK's 60,000 junior doctors. | As of 1 August, the target will be 48-hour-weeks for the UK's 60,000 junior doctors. |
| Contracts asking trainee doctors to work outside the regulations will be illegal and all rotas must be based on the 48-hour model. | Contracts asking trainee doctors to work outside the regulations will be illegal and all rotas must be based on the 48-hour model. |
| But individual doctors can opt out, although this has to be voluntary. | But individual doctors can opt out, although this has to be voluntary. |
| However doctors cannot opt out of taking 11 hours continuous rest out of 24, or out of ensuring they have 24 hours continuous rest out of each seven days. | However doctors cannot opt out of taking 11 hours continuous rest out of 24, or out of ensuring they have 24 hours continuous rest out of each seven days. |
| A spokesman for the Department of Health said: "Where a service needs additional hours of cover individual doctors can voluntarily opt-out of the 48-hour limit to provide this." | A spokesman for the Department of Health said: "Where a service needs additional hours of cover individual doctors can voluntarily opt-out of the 48-hour limit to provide this." |
| Only a few specialist areas will be exempt from the new rules. | Only a few specialist areas will be exempt from the new rules. |
| 'Sophistry' | 'Sophistry' |
| But the British Medical Association said evidence on the ground contradicted the claim that the NHS was ready for the change. | But the British Medical Association said evidence on the ground contradicted the claim that the NHS was ready for the change. |
| Dr Andy Thornley, chairman of the BMA's junior doctors committee, said: "We are not reassured by government reports that the NHS is 97% compliant with the new working time regulation as we fear many junior doctors are being pressured to lie about their hours. | |
| "And our members are worried about their training; many feel it has reduced in quality as working hours have been reduced." | "And our members are worried about their training; many feel it has reduced in quality as working hours have been reduced." |
| NHS organisations have told us consistently that they are ready David Grantham, NHS Employers | NHS organisations have told us consistently that they are ready David Grantham, NHS Employers |
| He said it was possible to meet training demands and maintain patient services, but that managers would need to rely more on consultants than they do now. | He said it was possible to meet training demands and maintain patient services, but that managers would need to rely more on consultants than they do now. |
| But John Black, president of the Royal College of Surgeons, said the government had failed to listen to its concerns about needs within surgery. | But John Black, president of the Royal College of Surgeons, said the government had failed to listen to its concerns about needs within surgery. |
| "It is sophistry for the Department of Health to on the one hand deny an opt-out for surgeons that would enable us to organise safe patient care and good training but then hope doctors will opt-out individually to cover staff shortages to keep the service running." | "It is sophistry for the Department of Health to on the one hand deny an opt-out for surgeons that would enable us to organise safe patient care and good training but then hope doctors will opt-out individually to cover staff shortages to keep the service running." |
| But David Grantham, of NHS Employers, said: "NHS organisations have told us consistently that they are ready for implementation of the directive for junior doctors. | But David Grantham, of NHS Employers, said: "NHS organisations have told us consistently that they are ready for implementation of the directive for junior doctors. |
| He added: "It remains appropriate that outside of exceptional or emergency circumstances, such as a flu pandemic, doctors like other health professionals, and their patients, should be protected by the reasonable controls on working hours set out in the working time regulations." | He added: "It remains appropriate that outside of exceptional or emergency circumstances, such as a flu pandemic, doctors like other health professionals, and their patients, should be protected by the reasonable controls on working hours set out in the working time regulations." |
| But shadow health minister Stephen O'Brien said: "Labour's failure to negotiate an opt-out for junior doctors will compromise NHS services and could undermine patient care. | But shadow health minister Stephen O'Brien said: "Labour's failure to negotiate an opt-out for junior doctors will compromise NHS services and could undermine patient care. |
| "As swine flu puts an increasing strain on our hospitals the need for the opt-out is even greater." | "As swine flu puts an increasing strain on our hospitals the need for the opt-out is even greater." |