The difficulties of recruiting doctors to the NHS and then keeping them there boils down to two factors - pay and conditions.

Doctors complain that had they chosen to follow another career path - say law or banking - they would be paid a lot more for doing a lot less.

And a survey showed that one third of doctors would not choose medicine if they were starting their careers now.

The result is that GPs are short on the ground, many hospital doctors prefer to spend their time practising private medicine - where the rewards are greater and the pressures fewer - and many junior doctors abandon medicine at the first opportunity.

However, the government has said it is taking action to address the problems.

In July 1998, then Health Secretary Frank Dobson said up to 7,000 more doctors would be recruited to the NHS over the next three years. In addition thousands of extra training places will be created.

What doctors say

The British Medical Association News Review magazine carried out a poll which found that more than four in 10 doctors would not advise school-leavers to choose medicine as a profession.

Halifax consultant anaesthetist Dr Peter Bamber told the magazine: "The medical profession is now a poor career choice for an intelligent, aspiring young person."

Berkshire GP Dr Jennifer Langdon said: "I think the profession's future is bleak and if I were 10 years older I would retire now."

BMA leaders drew up an action plan to make medicine attractive again, and stop doctors leaving the NHS.

It included:

• Improved working conditions including shorter hours and better accommodation for doctors on call;
• Flexible working patterns family-friendly shifts, in-hospital creche facilities;
• Better pay;
• More hospital doctors to relieve pressure on existing staff;
• More student exposure to general practice so that new recruits can learn about the benefits of a career in primary care;
• Moves to help GPs who have taken a career break get back into full-time work.

This last point was recently addressed by the government, after negotiation with the BMA, with a scheme to attract GPs who leave the profession back to medicine.

The new GP retainer scheme will help keep doctors in touch with developments in medicine by working on a part-time basis while they take a career break, so that they can practise again in future years.

At present, many doctors are permanently lost to general practice because they find it very difficult to keep abreast of developments. It costs more than �250,000 to train a GP.

Pay issues

However, pay remains a difficult point. Over the years, doctors' pay has fallen behind that of comparable professions.

But public sympathy is usually reserved for nurses, as a fully-qualified, full-time doctor in the NHS will earn at least �45,000 a year.

A Department of Health spokeswoman said: "The government has taken a number of measures to improve recruitment and retention of GPs."

These include:

• An increase in the number of medical training places by 1,000 a year over the next five years;
• The introduction of pilot projects and salaried schemes designed to offer doctors different ways of working;
• The creation of primary care groups that give doctors "more power and influence than ever before".

The spokeswoman said consultants already had flexibility built into their working lives, as they were only contracted to work for the NHS for part of their time.