It sounds like a marvellous idea—a cross between John Mortimer's Rumpole of the Bailey and James Herriot's All Creatures Great and Small. But are medical chambers a pipe dream or a serious way forward for the NHS?

Since the BMA produced a discussion paper on setting up medical chambers last May, some consultants have begun collaborating in private practice under formal partnerships and limited companies, while continuing on 10/11ths NHS contracts. But how far do such part time collaborations go in testing the private chambers concept, and what effect would private chambers have if they did spread across the NHS?

According to the BMA's concept of medical chambers, consultants would become self employed, free standing practitioners, working from private chambers with fellow clinicians, who charge the NHS per service supplied. The beauty of it would be more independence, possibly higher incomes, and no more management or administrative duties unless one opted into these (and charged accordingly).

Part time private collaborations among doctors who sell their services to the NHS are widespread across pathology and anaesthetics, and there is talk about setting up such arrangements in cardiothoracic surgery, ophthalmology, and orthopaedics.

Pathology is suitable for the group approach because of severe …