NHS: Working Time Directive (Hansard, 17 July 2003)

§ Lord Warner
My Lords, we move seamlessly from smoking to the Working Time Directive. The directive already applies to all NHS staff except doctors in training, to whom it will he extended from August 2004. The Department of Health is actively working with the NHS and the medical profession to implement this change in ways which will benefit both patients and staff. Solutions will vary from NHS trust to NHS trust, but will include using staff differently by, for example, creating night teams to staff hospitals out of hours.

§ Lord Skelmersdale
My Lords, I am grateful for that Answer. If I were of a suspicious frame of mind, I would wonder whether I had left my prepared supplementary lying around in the Library. The Minister's honourable friend, Mr Hutton, stated in a press release today: Further measures were announced today by the Department of Health to ensure that the NHS complies with its obligations". The directive goes on to say much of what the Minister has already said. This, very sensibly, involves talking to the strategic health authorities. Is the Minister aware that the department has only seven months before the eagle eye of the Commission will be directed at this country on that particular matter? At the end of that time, he will have run out of time to use the derogation for extending the time limit beyond August next year for another two years.

§ Lord Warner
My Lords, I have not seen the noble Lord's prepared supplementary, but I reassure him that we have not been sitting idly by. He may not be aware that some time ago we set up a Working Time Directive expert group, which had on it people from the Royal Colleges, the JCCs, the NHS Confederation and other key stakeholders, who have been working together on the issue. There are 19 Working Time 974 Directive pilots that have been going on for some time, which are working out new ways of working locally that will help to deal with the implementation. A great deal of action is taking place in that area, and we have been putting aside money for the pilot sites and to help trusts to implement the Working Time Directive when it comes into force.

§ Lord Clement-Jones
My Lords, the Minister talks about actions being taken, pilots, discussions and so on and so forth. Is it not the fact that the NHS is not yet ready for the introduction of the Working Time Directive in the particular area identified? Why does he not accept the suggestion of the Royal College of Physicians that the introduction of the Working Time Directive be delayed?

§ Lord Warner
My Lords, we are not convinced that the Working Time Directive does need to be delayed. I can certainly write to the noble Lord. I shall not bore noble Lords with all the details, but I can refer to the 19 pilot sites, where some very interesting work is going on about the way in which pressure can be taken off senior house officers, for example. We can reorganise the work so that out-of-hours services are producing benefits for patients as well as coping with the Working Time Directive.

§ Baroness Gardner of Parkes
My Lords, can the Minister tell us how he can reconcile his remarks that he is quite confident that everything will be all right in 2004 with the press reports which indicate that many accident and emergency wards might have to close because there will simply not be enough junior trainee doctors to handle the work?

§ Lord Warner
My Lords, I wish the noble Baroness a happy birthday. As part of her birthday gift, I assure her that we do not accept that services will close as a result of implementing the Working Time Directive. I draw the House's attention to the fact that we have implemented the Working Time Directive for other NHS staff—for a much larger group of people. That came into force in 1998.

§ Lord Elton
My Lords, will the Minister tell us what the cost of the introduction will be, and whether it is already included in the public expenditure forecasts in the Red Book?

§ Lord Warner
My Lords, what I can say is that we know that the Government have committed themselves to increasing NHS funding by on average 7.4 per cent in real terms in England over the next five years. That includes provision for the impact of the Working Time Directive. We have also set aside £46 million over the next three years to help trusts to implement the directive. More than £5 million has already been dispersed so far this year to the 19 Working Time Directive pilot sites that are trialing new and better ways in which to work.

§ Baroness Finlay of Llandaff
My Lords, will the Minister inform us what action the Government are taking to manage the tension between the local delivery of services and the need for a critical mass of specialists to manage very sick patients on a 24x7 basis?

§ Lord Warner
My Lords, the Government have already put in place a large increase of well over 1,000 extra specialist registrars. They will be concentrating the allocation of those posts in the trusts that might have the greatest difficulty in tackling the problems around the Working Time Directive.

Lord Berkeley
My Lords, my noble friend will be aware that the Working Time Directive also applies to railway workers. My noble friend Lord Sainsbury recently told the industry, through this House, that it had known about that since 1999 and should have been fully prepared. Presumably my noble friend the Minister has taken that advice himself, and will be fully prepared for the extra year that the medical workers have been given, beyond those on the railways, so that everything will be in order by next August.

§ Lord Warner
My Lords, you will be astonished to know that I am not briefed on the question of railway workers. That subject is a little wide of the Question.

§ Lord Chan
My Lords, in the matter of the long-term solution, surely we need to ensure that our medical students are being trained in sufficient numbers. Will the Minister give us information about that, and tell us whether in any way the changes will mean that we still have to recruit people from developing countries?

§ Lord Warner
I assure the noble Lord that we have made significant investments in training postgraduate doctors. By 2005–06, we will be spending £1.4 billion on postgraduate medical and dental training. That is a 22 per cent increase over three years.

§ Lord Colwyn
My Lords—

§ Lord Williams of Mostyn
My Lords, I am afraid that we have run out of time.