Paper Short Abstract:

While the question of how many doctors a healthcare system needs has long animated the correspondence columns of medical journals, this paper interrogates the problematics and politics that have encircled such planning, in various ways, since the end of WWII.

Paper Abstract:

The perennial question of how many doctors the UK’s National Health Service (NHS) needs is often answered in one word: “more”. The question itself sounds as if it should be data-driven, calculable and amenable to some kind of quantitative logic. Yet, health workforce (or what used to be called “manpower”) planning efforts have arguably been characterised by their ‘ad hocery” from the very inception of the NHS (Maynard and Walker, 1977, 62). Indeed, it was only in 2023 that a NHS Workforce Plan was finally published after roughly two decades without any kind of strategy, despite repeated warnings of a ‘staffing crisis’. This paper therefore starts in the present and refers back to the past to consider the power and politics of (a persistent lack of data) for health workforce planning.

While the question of how many doctors a healthcare system needs has animated the correspondence columns of medical journals such as the BMJ and the Lancet, the problematics that encircle such planning have not yet captured the attention of anthropologists. Given that the ‘medical manpower problem’ is one of global scale and scope, the issues of ‘data’ – and where to find them – are even more profound. Even now, data on the number of medical personnel actively employed, flows of medical migration, training patterns and career trajectories is imperfect even in the richest of countries. And, without accurate data in the present, planning for future staffing needs will only be ‘ad hoc’ and its accompanying politics fraught.