The different methods of pay negotiations underlined the administrative di­ vision of the medical profession into general practitioners and hospital staff. There was virtually no career structure in general practice; the young doctor left hospital after one, two, or more years of experience, usually to become an assistant in an established practice in which he hoped before long to be­ come a partner. In hospital practice there was, however, a well-defined model, prescribed under the Spens Committee report of 1948 and based on conditions pertaining in the major voluntary hospitals in the prewar period. This pattern was subject, in the first years of the National Health Service, to the strains not only of an evolving national staffing structure but also of in­ creasing medical specialization. Not surprisingly, problems soon developed at all levels of hospital staffing, and there was an increasing need for a new staffing policy.