It is one of the wonders of the modern world, that the nation's professional organisations (and, in particular, the medical profession) whose members tend to vote for conservative governments who have such values as "de-regulation", "competition", "free markets", "freedom of choice" and "competition" are, within their organisations, the greatest supporters of anti-competitive policies, of lack of freedom and lack of freedom of choice, lack of competition, and favour closed shops in a way that modern trade unions have been unable to emulate. Now surgeons are facing a challenge on training. Will an alternative to specialist training bring change for the health consumer or will it merely bring new members to the same club?