Huge disparities between projected numbers of NHS staff and the levels of personnel the health service actually needs—or can afford—have been shown in a government report leaked to the Health Service Journal.

The draft NHS pay and workforce strategy for 2008-11 predicts a shortfall of 14 000 nurses and 1200 GPs but a surplus of 3200 consultants by 2010.

As a partial solution the report suggests that a lower paid “sub-consultant” grade be created for doctors who have newly acquired their certificate of specialist training, but the suggestion has prompted an angry …