'No-one blew the whistle hard enough when the new processes started looking flawed'

Apart from the regular downpours, one recurring feature of my summer holiday this year has been e-mails from the Conservative MP Peter Bottomley, fanning the flames of outrage over the doctors' training fiasco. Whoops, here comes another one!

The former minister and husband of Virginia is not always right. But he is always worth listening to and if I were a voter in Worthing West in need of help I would take comfort from knowing that my MP is famously tenacious.

Having ploughed through Mr B's e-mail stack and talked to the usual suspects - MPs, doctors, officials - I am still not on top of what is a very complex controversy. It has left 30,000 UK trained doctors starting new jobs on 1 August - and 13,000 still looking.

As you probably know, many in both camps still seem very cross over treatment which has maximised anxiety and frustration. The blame game is under way, but not just that. By common consent some of the most talented applicants have not got jobs because of the way the application forms were drafted and processed (plagiarising smart answers seems to have been a better tactic than getting a PhD). The repercussions for the NHS may last for years.

A new 'lost tribe' of medics may be created unless the situation can be rescued. They may be reduced to becoming the equivalent of supply teachers or be forced to emigrate, say harsher critics, because the rules do not give them a second chance.

Andrew Lansley, the shadow health secretary, is not alone in arguing that the original policy - Modernising Medical Careers - was flawed and that the Medical Training Application System, which implemented it, turned out to be less than brilliant. What's more, no-one blew the whistle hard enough when the new processes started looking flawed last autumn. Why? Because the royal colleges, the British Medical Association, ministers, and chief medical officer Sir Liam Donaldson all had fingerprints on the deed.

Mr Bottomley admits that MPs (himself included) and the health select committee didn't shout enough either. Dr Richard Taylor, independent MP for Wyre Forest, has now persuaded the busy committee to do a 'quickie' investigation about the time Professor Sir John Tooke's inquiry into MMC reports in October.

Dr Taylor is impressed by Sir John, but less so by Whitehall's failure to pilot the now discredited MTAS or the way in which MMC requires aspiring specialists to choose their specialism far too early - after two years - without the necessary flexibility to change later.

One of those stranded by this year's cock-up, Dr Matt James, one of the Remedy UK doctors who took MMC to the High Court (and lost), agrees. 'Becoming a consultant surgeon at 30 under MMC changes is just too young,' he says.

Of course, restrictions imposed via the EU's working-time directive are part of the problem. More doctors are needed to meet shorter hours' requirements, but they get much less hands-on experience over fewer years.

Mr Bottomley remains cross for a host of reasons, not least the treatment of foreign UK graduates who suddenly had to get visas and passport stamps.

Why not copy the US (just this once) and let a computer match the applicants' order of priorities with the hospitals' order of priorities?

But his current gripe is the way the Department of Health seems to have slipped out Professor Neil Douglas's gently scathing review of MTAS and MMC - 'the biggest crisis within the medical profession in a generation', it concluded, before proposing sensible changes. The report is dated 12 July but was only posted on the MMC website on 3 August - after Parliament went into recess - with no accompanying press release from the DoH. A few MPs were notified, concedes Mr Bottomley.

Result? Very little media coverage, though he exempts HSJ and The Sunday Telegraph from what has become a semi-public row over BBC non-coverage. 'Paxo was hopeless on Newsnight,' he complains.

Deliberate media manipulation or another shambles? I have not got a final answer, but precedent points to the former.

To read health minister Ben Bradshaw's response to this column, click here