Working Time Directive (Situation in the UK)
Three recent articles from BBC highlight the problems faced by the NHS in implementing the working time directive.
Warning over junior doctors' hours
Doctors will be limited to a 56-hour week
Hospitals risk legal action because they are failing to meet a deadline on junior doctors' hours, the British Medical Association (BMA) has warned.
Tough new limits on junior doctors' working hours come into effect on Friday.
NHS trusts are required to implement a national agreement, but it is feared about 30% of junior doctors in Scotland still work excessive hours.
BMA Scotland says doctors could sue trusts which do not change their system.
The limit on junior doctors' hours were drawn up 12 years ago, but have only now become legally binding on health trusts.
From Friday, no junior doctor should have to work more than 56 hours a week, or 72 hours including on-call time.
The cap is in response to concern about the possibility of overworked staff making mistakes and putting lives at risk.
Nobody wants to see doctors being forced to take legal action, but because of the lack of preparation by some trusts, it may happen
Jim McCaul, chairman of the BMA's Scottish junior doctors' committee, said: "For too long now junior doctors have been working excessive hours and we need to consign the days of patients being treated by dangerously tired doctors to the past and this is an important milestone.
"If a doctor is working outside safe hours limits and they fall asleep at work or become ill because of stress, their trust could now be liable.
"Nobody wants to see doctors being forced to take legal action, but because of the lack of preparation by some trusts, it may happen."
Dr Ian Thompson, a senior house officer at Woodend Hospital in Aberdeen, said: "I think it's an important change to provide this health and safety legislation that's going to help to improve care by providing patients with somebody who is rested and fit to treat them."
'Spirit, not letter'
The limits were initially introduced as guidance and have applied to first year doctors since 2001, but are now contractually binding for all junior doctors.
The chief executive of Highland Acute Hospitals NHS Trust, Richard Carey, hoped an element of flexibility would exist in the new system to allow "the spirit of the contract rather than the letter of it" to be applied.
He said: "One of the problems is that it is a bureaucratic system and a number of staff have spent vast amounts of time monitoring and recording information in order to demonstrate compliance to the national group.
"This has caused a number of people to be very frustrated by the whole system."
Health Minister Malcolm Chisholm said he expected "the vast majority" of junior doctors to be working within the limit "very soon". He defined this as "safely within a year".
"The reality is that nothing was done about this problem in the 1990s," Mr Chishold said.
"There has been a great deal of positive activity recently but we have to admit that in the past this problem was neglected.
"More needs to be done but I think we should recognise what has been achieved through the partnership approach."
In a year's time trusts will also have to comply with the first phase of the European working time directive, which is even more stringent.