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Education And Debate

Collings report on general practice in England in 1950: unrecognised, pioneering piece of British social research?

BMJ 1995; 311 doi: (Published 01 July 1995) Cite this as: BMJ 1995;311:40
  1. Roland Petchey, lecturer in general practicea
  1. aDepartment of General Practice, Medical School, Queen's Medical Centre, Nottingham NG7 2UH
  • Accepted 9 March 1995

Collings's grim description of postwar general practice in England and his sombre analysis of its prospects created an immediate sensation. In addition to its value as a historical document, the report is also regarded as a turning point in the postwar history of British general practice. The study is also interesting for another reason, which has not been acknowledged: Collings merits recognition as a pioneer of ethnographic research at a time when it was largely unknown elsewhere in British social research.

J S Collings's survey of English general practice was published in the Lancet on 25 March 1950.1 His grim description of postwar general practice and his sombre evaluation of its prospects (box) created an immediate sensation. His report, however, is of more than antiquarian interest. Within British general practice it has acquired semimythical status. It has been acclaimed a “classic report,”2 “the most devastating attack on the image of the family doctor,”3 and “an Exocet fired right through the basis of general practice.”4 More positively, it has been hailed as a turning point,5 the single most effective factor in mobilising opinion in favour of constructive change,6 and a seminal contribution to the formation of the Royal College of General Practitioners.7 I will argue that Collings also deserves to be recognised as a pioneer of ethnographic method in British social research.

Origins and publication of the report

The Collings report is unusual in several regards. Firstly, Collings seems an improbable choice as researcher. An Australian, he had previously worked in New Zealand as a general practitioner and in Canada as a medical officer of health. At the time of the report he was a research fellow at Harvard University School of Public Health. Despite this wide ranging experience, he had never visited Great Britain so was unfamiliar with the …

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