§ Dr. Murrison
To ask the Secretary of State for Health what assessment he has made of the costs of implementing the European Working Time Directive in(a) money terms, (b) extra doctors required and 412W (c) other extra NHS staff required for (i) August 2004 and (ii) 2009; and what methodology he used to calculate those figures. 
§ Mr. Hutton
[holding answer 30 March 2004]: The Working Time Directive (WTD) is an integral part of modernising and improving services. The National Health Service has been aware of the implications of implementing the WTD for doctors in training since 2000, and planning for it forms part of overall NHS planning.
In the United Kingdom's response to the European Commission's questionnaire on working time, which was completed in February, we stated that in the UK the NHS would need to recruit several thousand extra middle grade doctors by August 2004 to achieve compliance with the re-interpreted Working Time Directive, while simultaneously maintaining current levels of service provision and retaining similar working practices as now. The cost of recruiting the extra middle grade doctors would run to hundreds of millions of pounds per annum.
However, this is not a realistic scenario. Even if this number of additional doctors were available, implementing the directive in this way would be very inefficient. As stated in our recent response to the EC's communication on working time, solutions need to include alternative ways of working that are already being piloted in the NHS, such as substituting non-medical practitioners where possible, instituting new forms of multidisciplinary team working, or redesigning services in some areas. There is no 'one size fits all' solution and ways of becoming WTD compliant will vary between trusts. Actual costs or numbers of additional staff required are not held centrally and could not in any case be disaggregated from the overall cost of NHS growth and modernisation.