§ 5. Mrs. Helen JacksonTo ask the Secretary of State for Health how many junior doctors are (a) contracted for and (b) working more than 72 hours per week. [33213]
§ Mr. MaloneOur task forces reported that, as at 8 February this year, 768 hard-pressed on-call posts still required action to comply with our aim to bring all such posts within 72 contracted hours. That was a reduction of 88 per cent. from the position in March 1994. A further 1,776 posts in the less onerous, non-acute specialties are due to be brought down to 72 contracted hours by December 1996.
§ Mrs. JacksonI thank the Minister for his reply, but has he seen the big notices on motorways which say that tiredness can kill, and that applies to lorry drivers whose maximum working week is a mere 45 hours? Is he aware that the 72 contracted hours level that has been agreed is an average, not a maximum, and that as many as six out of 10 junior doctors may regularly be working more than 72 hours? Does he agree that an exhausted young doctor in a hospital ward where the nursing staff is overstretched must be a danger to patients' safety?
§ Mr. MaloneI suggest that the hon. Lady considers the signs in her constituency, never mind signs on motorways. Northern general hospital has one of the best records in cutting hard-pressed posts—there are none at all over 72 hours. Only 14 per cent. of juniors are working more than 56 hours, which is less than half the national average, so perhaps, when she looks for success in this policy area, she might best look at home.
Of course, we do not want junior doctors who are exhausted. That is why, since 1991, 1,150 extra doctors have been brought into the health service to help reduce hours and why we are determined not just to reach our targets on the 72-hour commitment, but to work with junior doctors to ensure that the real time worked comes down to 56 hours as well.
§ Mr. Harry GreenwayWhy do some junior doctors work much longer hours than the average and than those who work a normal week? Is better management required? Is work going on to achieve that?
§ Mr. MaloneMy hon. Friend is right to point out the variations that take place across specialties. The reason for that is straightforward. Different specialties require different work patterns. For example, in some specialties, a large proportion of the time is spent on call; in others, 1439 the work is especially active. That is the reason for the variation across specialties, but of course we are trying to ensure that we come within the overall targets set.
§ Mr. Nicholas BrownI congratulate the Minister of State on surviving the ministerial reshuffle. Given the increasing commercial pressures being placed by the internal market on hospital trusts, and given that the Government recently announced that the contracts of junior doctors are to be held by the trusts, not by the region or the Department, will he confirm that the hours worked by junior doctors now stand to be negotiated locally and that the wages and conditions of junior doctors also stand to be negotiated locally by the hospital trusts?
§ Mr. MaloneMay I congratulate the hon. Gentleman on not being whisked off to Australia with the Leader of the Opposition to deliver a lecture, but remaining here to ensure that the health policy set by his leader is observed by the right hon. Member for Derby, South (Mrs. Beckett). The question of junior hospital doctors' contracts and the custody of them is perfectly straightforward. They are best held at trust level. If they were held at regional level, we should have the curious experience of doctors becoming civil servants, which is not what anyone wants. The details are still being discussed with junior doctors but we are alive to their concerns. Deans will be responsible for the educational aspect of their contracts. I hope that we shall be able to resolve the matter in the not too distant future.
§ Mr. WatersonDoes my hon. Friend agree that the best measure of the Government's success in this area is not only that 96 per cent. or so of junior doctors are meeting the new deal targets on hours but that we are beginning to hear comments from the profession itself suggesting that junior doctors are missing out on vital experience because they are required to clock on and off, as it were, to meet some of those targets?
§ Mr. MaloneMy hon. Friend is quite right to point out that such comments are increasingly being made by junior hospital doctors, but, despite that, I must stress the Government's commitment to ensuring that those targets are met. We are determined that they should be met, but it depends, of course, how each trust configures the service. It must be done with two things in mind: reducing the burdens on junior doctors and ensuring that they get proper and flexible training.