VIEWS OF DOCTORS IN THE UNITED-KINGDOM ABOUT THEIR OWN PROFESSIONAL POSITION AND THE NATIONAL-HEALTH-SERVICE REFORMS

Background In the course of national studies of doctors' career choice s and progression, we received spontaneous comments from respondents a bout job satisfaction and the National Health Service reforms. To asse ss whether such comments were representative, or whether they reflecte d minority views, we added questions to subsequent questionnaires to g auge systematically how doctors view their own professional position a nd the wider NHS, Method Self-administered questionnaires were sent to all 10504 qualifiers of 1977, 1988 and 1993 from UK medical schools. Results A total of 7391 responded (70 per cent). Most doctors in UK me dicine were positive about the career opportunities they have had (66 per cent of relevant respondents), their future prospects (68 per cent ) and their present position (80 per cent). Few were positive about th e NHS reforms (9 per cent) a nd the effects of the reforms on their ow n professional work (9 per cent). Only 0.2 per cent of the 1993 qualif iers scored their impression of the internal market as 'strongly favou rable'. Conclusions In recent years the NHS shifted from a collaborati ve to a competitive model of management of health care with the establ ishment of an internal market. The great majority of respondents viewe d recent changes and the internal market unfavourably. This is not, ho wever, a reflection of more widespread discontent with their work. The majority viewed their own professional opportunities and present posi tion favourably.