How many bonuses have been paid to and fines imposed on NHS Trusts for compliance with the targets and standards of the New Deal for Junior…

The system of bonuses and penalties for Trusts based on performance against New Deal targets and standards which I announced in September 1999 was intended to act as an incentive to overcome the remaining obstacles to full compliance. At the time the latest returns from Trusts indicated that only 10% of junior doctors in Scotland were working outside the 56 hour limit. The detailed work which the New Deal Implementation Support Group (ISG) undertook with Trusts prior to its report to me in March 2000 revealed that the scale of non-compliance was greater than previously reported. In the light of information from the ISG, I informed Trusts that, while I remained determined that junior doctors' hours and working conditions must be improved as a matter of priority, I would postpone the imposition of financial penalties provided that they initiated remedial action. The ISG has since worked with Trusts to identify problems and develop solutions in this area. The concept of introducing incentives for those Trusts to meet New Deal targets has subsequently been incorporated into the agreement between the UK Health Departments and the BMA for a new contract for junior doctors. The contract which took effect from 1 December will reward the most hard pressed junior doctors and provide a real financial incentive for Trusts to reduce doctors' hours. The cost to Trusts of non-compliant posts will increase significantly at intervals throughout the next two years. The Scottish Executive has worked with the Scottish Junior Doctors' Committee (SJDC) and NHS Trusts in Scotland to implement the contract.