This paper covers the spread of, and interactions within, the medical workforce in recent decades. It does this in order to illustrate the way in which a bias towards hospital and specialist care has occurred. This bias is the result of the continual expansion of hospital overnight inpatient care. The expansion is against the OECD trend. It has caused an excessive level of specialist training and the diversion of domestic medical graduates to the non-GP specialties, thus limiting the numbers who specialise in General Practice. This trend away from General Practice has resulted in high dependence on overseas recruitment of GPs, especially in rural areas, from where most of these overseas doctors move to the cities in time.

Because some findings in this paper run against popular perception, particular attention is paid to the compilation and presentation of data. These data are available from a wide range of sources. The findings are then fully discussed in the last section. The essential picture is one of oversupply and maldistribution. The problems as identified are probably not remediable without a major change in emphasis within, if not of the structure of, healthcare provision. A detailed knowledge of the medical workforce on the part of the reader is not assumed.