YOUR article on junior doctors' hours sheds welcome light on their working patterns ("Revealed:

junior doctors working 90 hours a week", The Herald, October 7). How do we remedy the situation?

The first issue is around allocation of staff. This is decided at a central level for doctors in training. Traditionally there has been a bias towards hospitals in large cities receiving more trainees than the shires, in absolute terms, and in terms of a per capita basis for the workload. Some central departments have three times the trainees compared with more distant ones with similar workloads. As a manager trying to staff a department, you are dependent on others whom you may not be able to influence to allocate you staff with which to run a service as best you can. You are also constrained by national agreements on pay which make it impossible to incentivise any hard-to-fill posts, unlike in England.

To make rotas more humane, and therefore safe, requires more doctors. This is not going to happen any time soon. It is clear that we are reluctant as a society to pay for all these additional posts, and have lost almost half our available workforce abroad, in emergency medicine at least, to more attractive pay and conditions. Ten years ago if I advertised a job I might get 250 CVs, many from doctors trained abroad. Now I will often get none, as a result of immigration legislation, and the fact that a doctor in India (especially with UK training) will earn more in that country, Australia or the UAE than the UK. Medicine is an international market, like banking. The contrast between the arguments to protect the "talent" in the City and an NHS short of doctors should be noted.

Of course, the answer is that we should make consultants work harder. However, in the last 12 months, most of my senior colleagues all over Scotland have done periods of duty that are every bit as bad as the ones described in your article, or worse. You make the point that all of the jobs in your article are European Working Time Directive (EWTD) compliant, and so they should be, but, if consultants had paid attention to EWTD patterns, the service would have imploded within the past three years.

Mr David Chung,

Consultant in Emergency Medicine, NHS Ayrshire and Arran.

THE law is an ass was the damning conclusion Mr Bumble came to in Charles Dickens's novel Oliver Twist. When it comes to European Union (EU) law, it is its implementation in Scotland that is asinine.

I read with horror your story about junior doctors working 90 hours a week.

Junior doctors are having to work more than 90 hours a week in some Scottish hospitals despite European laws to tackle the exhausting shift patterns that doctors claim risk patient safety.

What is the point of my colleagues and I coming together with various experts in the field of working time and health and safety, to draft legislation to protect

What sense does it make for a health board such as Ayrshire and Arran to adopt rules that state staff should work no more than an average of 48 hours and then in practice have a maximum working week of 91 hours, comprising seven consecutive day shifts of 13 hours?

We learn that although these shift patterns do not technically breach the European Working Time Directive (EWTD) they most certainly breach it in spirit. Seemingly NHS managers are allowed to implement these practices as long as they show "average" working patterns are below 48 hours per week over a period of six months.

I for one would not like to think the doctor treating me was at the end of a seven-day, 90 hours rota, of long shifts. This is harmful to the doctor's health and potentially dangerous for the patient.

That is not how our NHS should be run.

David Martin,

Labour MEP (Scotland),

43, Midlothian Innovation Centre,

Roslin,

Pentlandfield,

Midlothian.

COSMETIC Botox, facial fillers and body-building stimulants are not obtained free of charge, so those requiring NHS treatment for complications should meet the cost of this and seek recompense from the providers ("Hundreds admitted to hospital after Botox injections", The Herald, October 5).

The NHS should not be expected to provide for misguided vanity issues.

R Russell Smith,

96 Milton Road,

Kilbirnie.