Leading Article: A case for treatment

It seems it can be very damaging to your health to fall out with Britain's junior doctors. The British Medical Association chairman, James Johnson, was forced to resign last weekend for failing to reflect the anger of his junior colleagues in a letter he wrote to a newspaper. Junior doctors are also calling for the resignation of the Health Secretary, Patricia Hewitt. If a judicial review they have brought against the Government goes their way tomorrow, they might even be successful.

At the heart of this controversy is the new computerised system established by the Department of Health to allow 34,000 junior doctors to apply for 18,500 training posts. The new process has clearly been a shambles. The website crashed repeatedly and has been subject to two security breaches. To this extent the junior doctors have a perfectly legitimate grievance against the Government.

But a sense of proportion is necessary. The complaint of many junior doctors is that a great deal of talent is about to be squandered by the NHS because the best doctors are losing out to those with the best literary skills. But this is quite separate from the alleged shortage of posts. The shortage is of training posts that lead on to consultant status for which there is, quite rightly, stiff competition. Those junior doctors who are unsuccessful will not be excluded from the NHS. They will still have options open to them of staff grade posts, doing the same essential work of the NHS, but in non-teaching hospitals. Moreover, they can always re-apply for training next year.

The plain fact is that not all doctors can be senior consultants. There will always be a need for support staff. The problem seems to be that British doctors have traditionally tended to get the top jobs, and doctors from overseas have come in to fill the gaps below. But since 1997 there has been a massive expansion in the intake of the UK's medical schools. The result is that in Britain we are now self-sufficient in medical staff for the first time. So it is hard not to conclude that one of the things these doctors are also angry about is the greater competition they are facing for the best jobs. This may not be to their liking, but patients surely gain from an abundance of doctors. Incidentally, we should also remember that all doctors have been awarded very favourable pay deals in recent years. Despite the ferocity of their complaints, there is no immediate financial penalty for junior doctors who miss out on training.

No one, not even the Government, disputes that the new training application system has been a disaster. But junior doctors should be careful to focus on the area where they have a genuine grievance - or risk undermining their case.