Planning is needed to cope with new regulations

AMID rising fears of spending cuts hitting front line NHS services, the revelation that an A&E department has had to curtail opening hours has been immediately seized upon by campaigners. The unit at Kirkcaldy will be closed overnight for at least a week. Opposition MSPs have lost no time to voice their concerns, seeing it as more evidence of job cuts being made by health boards to save money.

The reasons for the curtailment of service, however, do not fit so neatly into a simple scenario of cost-cutting and sacrifice of front line services. The proximate cause of the problem is not a reduced budget as some would like to argue, but staffing problems caused by the European Working Time Directive. Introduced last August, this has had the effect of limiting junior doctor working hours to 48 hours a week. The resulting staff difficulty has been compounded by no locum doctors being available to provide cover.

None of this relieves the health board of its responsibility to plan ahead and to ensure that arrangements are in place to provide cover. But the problem here is regulatory change, not financial cuts. And while much of EU regulation is in patients' interest as much as staff, compliance can often involve additional costs and problems in arranging staff cover that cannot always be anticipated months ahead. The solution is to ensure as far as possible effective rotas to minimise delay and inconvenience to patients.