TY - JOUR T1 - Manufacturing doctors is one thing; sustaining working communities is quite another JF - British Journal of General Practice JO - Br J Gen Pract SP - 124 LP - 125 DO - 10.3399/bjgp23X732177 VL - 73 IS - 728 AU - David Zigmond Y1 - 2023/03/01 UR - http://bjgp.org/content/73/728/124.abstract N2 - In an age of mass-production and commodification it is not surprising that the governmental response to our increasing losses of doctors is to recurrently and rhetorically press for greater production and wider recruitment.But in doing so are we avoiding deeper human problems of community and ecology?September 2022. Another new prime minister. An economic and political maelstrom is about to break. Meanwhile there are new faces on the parliamentary front bench, but their rhetoric is already familiar. On Sky News (22 October 2022) the then new Health Secretary, Thérèse Coffey, sounded sincere in her emphasis: she said she would ‘bring a laser-like focus’ to solving our growing NHS problems, especially waiting lists for procedures and GP accessibility for patients.A senior GP spokesperson, Dr S, wearied but diplomatically patient, dismissed all this as mere wishful thinking: his colleagues’ crumbling workforce could not possibly deal with the extra demand entailed. The interviewer asked why our GP service had become so dysfunctional and depopulated.Dr S quickly cited the longstanding and relentless time-squeezed work pressures, now yoked in an ineptly disincentivising pensions arrangement. The contended issues became, yet again, about the adequacy and distribution of money and resources.Surely adequate money and resources are essential for any competent and compassionate health service: we have seen how they must, again and again, be defined and fought for. So this is an ongoing battle. Being unavoidable, it will necessarily return to our analysis and debates. Yet, however essential this theme is, it often obscures another, one that is equally essential but more nuanced and less quantifiable, so much less discussed — our loss of community.Dr S made no reference to this. His otherwise very pertinent observations about money, workload, and resources omitted an equally important and longstanding fact: that GPs generally no … ER -