John Reid has written to the European Commission, warning of the "severe impact" its working time directive will have on the NHS.

The health secretary has called on commissioners to review the rules, which from August will mean that junior doctors will not be able to work more than 58 hours per week, including time "on call".

The Department of Health has called on trusts to do all they can to meet the new restrictions, including the transferring of responsibilities to other staff, in the face of possible employment tribunals and fines.

Amid concerns expressed by the UK government, EU commissioner Stavros Dimas has said he recognises the "practical difficulties" for the NHS in this new directive, and has pledged to bring forward legislative proposals aimed at alleviating the problem.

However, ministers have warned that even if such plans were introduced, they would not be imposed ahead of the August deadline.

Changes

The British Medical Association has warned that such changes could be at least two years away.

"The NHS has to be prepared for significant change," said chairman of the BMA junior doctors' committee, Dr Simon Eccles.

"The working time directive is essential health and safety legislation - patients should not be treated by tired, overworked doctors.

"We would like to see the government preparing for the changes rather than investing all its energy in trying to get around them."

It was right that "on call" time be included as time worked, he added.

"A brief period of rest in a hospital on-call room, knowing you could be interrupted at any minute, is not the same as being at home," he argued.