At the same time, the number of young doctors exercising their right to come to this country from the Continent for training experience has risen sharply. Where 10 years ago there was stiff competition among Britons for training posts in general practice, many of these are now being filled by German, Dutch, Spanish and Greek trainees who find it hard to gain experience at home. The same is true of hospital traineeships. Some find they like living and working here, and stay on.
Since many of those from the Continent have had a more theoretical and less practical medical education than their British counterparts, they require more supervision. Their presence puts a greater strain on the system than would British trainees, whose attainment levels are known.
The situation is not yet alarming. British doctors are likely to benefit from experience abroad, and if young continental trainees enjoy their time here, this country will have gained that many more friends. Yet the danger for the NHS is clear. If morale sinks too low, British doctors will vote with their feet and stay abroad. Some of their places will be taken by their counterparts from across the Channel, but a net shortage seems possible.
Such shifts cannot have been intended by the architects of the NHS's reformed structures. With doctors, as with teachers, the Government has failed to enlist sufficiently broad-based support for its changes. Young doctors are showing that they have a way of expressing their sense of disillusion: with their feet. It is a trend that should worry Virginia Bottomley.