Abstract
You have written an excellent editorial in the November issue of JRSM. 1 All the ills of the NHS will filter down to prospective medical students.
What you say is correct, but what bothers me is how many young Consultants are giving up the NHS at about 50 years of age, and in my small sphere I know of about 10 and I know three who are in the process of resigning. Obviously, they work in Central London where there is private practice. However, when I speak to them, they are not giving up in order to spend more time in private practice. They are stopping because of the chaos in the NHS, because they no longer have control of their operating lists, because they cannot run a big practice reliably without the firm structure which has been obliterated by the European Working Time Directive, and finally because the pension pot ceiling has dropped so low.
Although I have no direct experience or evidence, I hear that this is happening outside London and in specialties where patients are prepared to pay a price-guaranteed package deal for individual procedures in Orthopaedics and General Surgery.
Inevitably, this will filter down the ranks to prospective medical students and give the message that the NHS is no longer such an attractive option.