Response

I am still unsure whether or not the letter from Dr Howarth and colleagues was meant as a piece of satire. However, I will give them the benefit of the doubt and take them seriously. In the 48 years since I entered medical school, I have come across many arguments in support of keeping the allocation of National Health Services resources, including those for teaching and training, skewed towards London and the South East. However, the dubious introduction of arguments about ‘meritocracy’, and the use of the names of authorities like Michael Sandel and Michael Marmot, marks a whole new level of creativity. I think that everyone up North would greatly welcome greater investment in our training programmes, and if there is a way that can be achieved without some redistribution of resources away from London, no doubt people with access to the finest facilities in the land will be able to find it for us.

Incidentally, I don't want to speak for Sir Michael Marmot, but I suspect that even people who live and work outside London may nevertheless have had the opportunity of speaking with him.