Mr. Anthony Owens:

First, to the Senator, I would say try to keep the faith. That is what we are doing. She is right that we do need a recruitment strategy, but at the moment we have something more like a removal strategy. The safest and surest way to build up the consultant capacity that we need is to train our own consultants. We are not doing that. We do not have enough training places and we are not bringing people through who could get into those consultant posts. This is something that will become very real. We took in the biggest ever intern cohort last year and the system has not put training places in place to get those people going through the system to be trained to be consultants. We are going to lose many of them. That is a removal strategy; they are going to go.

When people come to a consultant post, if they have had experience abroad, as Dr. Colleran said, they will not come back to work here for 30% less than their colleagues. They are not going to do the same work. Why would they? Why would they not stay in Australia or the NHS and be treated with respect and dignity in a system that actually values their contribution? That needs to be addressed and reversed. There are 728 consultant posts vacant or not filled substantively. That is incredible. These posts used to be like Olympic gold medals. We are not doing that properly.

I have referred numerous times today to the fact that public health medicine is our insurance policy. We have one third the number of the public health specialists who should be consultants as there are in Scotland, which has a similar population size and similar geographic dispersal of population. By virtue of the age profile, we will also lose a lot of people there and we will not be able to replace them. The next time this happens, if it happens again, we will not get away with it. We need to stop the removal strategy and move to a proper, sustained and focused recruitment strategy.