Sir, I am writing to explain to readers why I believe there was an overwhelming vote by England and Wales consultants against the New Consultant Contract.

Despite the public impression, there are relatively few senior doctors who would gain substantially over the next year or two.

There is growing and serious unrest in many parts of the medical profession with the Government over the running of the NHS in recent years.

We are now experiencing unprecedented levels of politicisation and political control, meeting spuriously imposed targets to the detriment of clinical priorities.

There is less opportunity for local hospitals and primary care trusts to address local issues.

We continue to be significantly constrained by inadequate resources coming to the " frontline" including equipment, facilities and doctor and nurse personnel.

I know from personal experience that to bring about modernisation of essential hospital facilities over the last six years has, on occasions, caused serious personal stress to the point of causing ill health.

This has not been the fault of hospital managers, but the lack of resources and lack of sufficient flexibility to address local NHS problems.

These difficulties affect consultants, GPs and nurse colleagues alike, and cause much professional and, at times, personal stress.

This is in a Government-accelerated atmosphere of high public expectations of the NHS, in some areas way beyond the capability of the NHS to deliver.

The England and Wales consultant vote of two to one against this new deal should act as a wake-up call to the Government.

I hope that Tim Collins will help convey this message to John Hutton, Alan Milburn and Tony Blair.

Mature discussion and debate is required between consultants (and GPs) and the Government rather than adversarial action.

Failure to do this risks an increasingly disengaged consultant body and a looming black hole for the NHS.

Dr Colin M.

Brown

Consultant Physician

Morecambe Bay Hospitals NHS Trust