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doi:10.1136/bmj.310.6995.1673c

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Purchasers cannot put the cart before the horse

Jeremy Wight,
Nick Payne

Senior registrar in public health medicine Consultant in public health medicine Directorate of Health Policy and Public Health, Sheffield Health, Nether Edge Hospital, Sheffield S11 9E1

EDITOR,—Trevor J Bayley suggests that, during their negotiations with trusts, purchasers of services should insist on an increase in the number of consultants in specialties in which the number of career registrars exceeds likely demand.1 Without this, he states, the many efforts to improve specialist training in Britain will have been for nought.

Firstly, the function of purchasers is to assess their population's health needs and negotiate the delivery of …