How big is your society?

Presumably nobody will ever know for sure what Margaret Thatcher meant when she said there was no such thing as society, and I can't see anyone reaching agreement on what David Cameron means now when he says that society does exist after all, and that it should be ‘big’. Or, presumably, bigger. Than what? Bigger than ‘no such thing’ is easy. And how do you measure society anyway? It bends the mind, this sort of stuff.

I am chairman of a civic society, it's the sort of thing GPs do when they stop being doctors. You can read about us on http://www.altonsociety.org.uk/ including the fact that ours is definitely a society we would like to be bigger. Size counts in a civic society. What's more we can measure it: we know exactly the number of membership subscriptions, and more to the point, the number of people who are prepared to serve on the committee and do things.

When I was in short trousers I patronised Workers Educational Association pre-retirement groups by lecturing them on how vital a retired generation, prepared to do things, is to society and how many civilised things would simply not be there without retired people running them and/or patronising them. I think that's a circle. Anyway, think of the sea of grey heads at any play or concert. And now the grey heads which are about to start staffing local museums and libraries.

Or not. Because it doesn't get any easier. The difficulty of getting people to do things has probably always been a topic of conversation, but more than ever today. Living in a small town I think we may know more about this kind of thing than David Cameron does, unless he puts in the odd stint for his local food group, like the one my wife chairs, or organises a local beer festival, like the one that has just been kicked out of a church converted from one of our wonderful old brewery buildings.

Our experience here, worryingly, chimes with the theory that getting involved in voluntary activities is not an age-related thing, but a generation-related thing. And it's not just the ‘me-now’, Thatcher youth thing: work today is increasingly driven by inhuman managerialism, which is unsympathetic, to put it mildly, to involvement in local activities. Moreover, the corporations for whom so many work have little regard for morality, let alone ‘society’, big or small. At the same time the instruments of communications technology have combined to raise our gaze from the immediate world of direct sense to the seductive, virtual universe beyond, in which we can only dream of playing an actual part. So, instead of looking to people we can know and touch as role models and examples of ‘success’ in life, we are brought magically close to the dazzling presence of celebrities and bankers. As Stephen Sondheim explained in West Side Story, ‘Golly Moses, natcherly we're punks!’

For the many years during which I was deeply unhappy about the direction the RCGP was taking British general practice, the one thing I always saw as unequivocally good about the College was its annual Spring Meeting. And the thing which made those meetings so special was that each was run by an organising committee drawn from the hosting GP community. These people were volunteers, throwing themselves into a process which dominated their lives for up to 4 years. And don't forget this was when they were doing one-in-four nights on duty, and numerous other aspects of practice now gone, such as taking bloods and syringing ears, home visits and chronic visiting.

I and several colleagues here in Wessex went through this process twice, for the 1994 and the 2004 Spring meetings, so this is another thing I know about. For example, I know we all regarded it as one of the most worthwhile things we ever did. So I don't know what David Cameron has got up his sleeve to bring this sort of ethos back. But politicians, for all the faults they may or may not have, are in it because they want to do things. To create an environment in which active involvement in society becomes a normal part of life once again would be a very good thing to do. I wish the project well, but I don't think anyone should underestimate its difficulty.

• © British Journal of General Practice, April 2011