This issue of the journal deals with an important aspect of health service provision: general practice. The contributors belong to the small minority in the medical community who are committed to ethical practice and are alarmed by current trends. They have grappled with some of the current controversies in general practice. They have identified issues which cause much discomfort within the medical community. They have analysed the history of these tensions, but they have come up with few solutions. This is because there are no simple solutions.