A Scottish hospital trust has become the first north of the border to be stripped of staff for failing to meet rules on reducing junior doctors' hours.

Grampian University Hospitals NHS Trust is set to lose four posts after being penalised under the Scottish Executive's "three strikes and you're out" rule.

The executive has warned that trusts must comply with New Deal terms over doctors' hours or face losing staff.

Six more posts in Scotland are also at risk, including positions in three other parts of the country.

We have endeavoured to look at patients' safety... and in so doing are not willing to compromise that for an hours target Dr Clifford Eastmond Grampian Hospitals NHS Trust

The executive said the trusts had only themselves to blame for their problems after being given "ample opportunity" to satisfy the terms of the New Deal.

The government's New Deal for junior doctors was introduced in 1991.

By August last year, all training doctors in their final year of medical education were supposed to be working no more than an average of 56 hours a week.

Despite two warnings, the rotas at the cardiothoracic department at Grampian University Hospitals Trust in Aberdeen still did not comply.

The trust said it had received a letter saying approval for four posts in the department had been withdrawn.

Compliance 'vital'

The latest edition of the British Medical Association (BMA) News says that Grampian also risks losing three further posts, while Fife, South Glasgow and West Lothian trusts may each lose one general medical post.

The British Medical Association said it was "ridiculous" that any trust failed to comply with the New Deal.

The chairman of its Scottish junior doctors committee, Jim McCaul, said: "I am disappointed that it has come to this in Grampian, but (the stripped posts) should be seen as a warning to trusts that they have to get this right for the sake of junior doctors and patients.

We are very disappointed that Grampian have not taken the chances given to them Mary Mulligan, junior health minister

"I am pleased the executive has lived up to its word and withdrawn approval for the posts.

"It sends a message that New Deal compliance is vital."

Deputy Health Minister Mary Mulligan said: "We are very disappointed that Grampian have not taken the chances given to them previously to put in place the correct rotas to ensure that they are compliant.

"Therefore we have had to take the actions we have, which is to withdraw the training posts from the trust."

She said funding for the training posts would be removed from the trust as soon as the staff were moved to another hospital.

"However, we will continue to work with the trust to try to reinstate those posts and at that stage the funding would be returned," said Ms Mulligan.

Inadequate levels

The trust will have 18 months to comply with the regulations.

However, assistant medical director Dr Clifford Eastmond defended the trust's actions.

"It is certainly possible to write rotas which are compliant," he said.

"It is certainly possible to ensure that junior doctors work to those rotas as much as possible.

"The problem is that some of those compliant rotas leave some very inadequate levels of doctors at some times.

"We have endeavoured to look at patients' safety alongside this and in so doing are not willing to compromise that for an hours target."