Ubi Scientia in the midst of the cosy cardigans of Caritas?

'And have you the heart to apply the prosaic rules of evidence to a case which bubbles over with poetical emotion?': Strephon, an Arcadian shepherd, implores of the Lord Chancellor in Gilbert and Sullivan's Iolanthe. To this impassioned pastoral entreaty, the Lord Chancellor replies robustly: 'Distinctly. I have always kept my duty strictly before my eyes, and it is to that fact that I owe my advancement to my present distinguished position.' Much of the response to the White Paper and subsequent Health Bill from GPs has resembled Strephon's pleading. There has been considerable focus on the human aspects of general practice: the special role of GPs; the importance of the doctor–patient relationship; continuity of care; and the professional values of GPs and doctors more generally. It is not surprising that we have reacted in this way. Defending our values is familiar territory. The curriculum of modern medical schools quite rightly incorporates ethical considerations and discussion about the doctor's role in society. What of Scientia then? GPs are more familiar than ever before with the clinical literature: 'hot topics' courses, GP updates, and a multitude of internet services promise to provide cutting-edge research (even if sometimes this requires one to have a different stance on aspirin prescribing every week). Many GPs are adept at critical appraisal and this is certainly a skill with which new trainees will be equipped from medical school. However, there is a distinct lack of engagement with health services research. Many find time to peruse clinical literature, but far fewer look at the Health Service Journal. Thinking about the larger system in which we work remains a minority pastime. The Health Bill has brought this to the fore; GPs will be taking on a gargantuan task, for which we are, in the most part, ill-equipped, under-prepared, and many find frankly daunting. There is some evidence about the likely effects of the reforms proposed in the White Paper and the perpetuation of a market-based healthcare economy. Some of this was described by the ever-eloquent Ben Goldacre in his Bad Science series. 1 The Royal College of General Practitioners (RCGP) must make full use of its members and staff who are capable of synthesising the available evidence and disseminating it in a digestible form in a way which engages the media, our patients, and the public at large. If, as it appears, there is good evidence that the …