Evolution of the health workforce: lessons from the past for the future.

Despite a doubling of the number of medical graduates almost 25years ago, shortages and persistent distribution problems remain. Policies to direct graduates to areas and specialties of greatest population need have been too little too late. Rural regions and areas with high need continue to be underserved, while the gulf between general practitioner and specialist numbers widens. Recommended reforms have been slow and fragmented, with limited success in addressing fundamental distribution challenges across geography, specialties and professional types. Current reforms need to move much more quickly and require significant additional investment to ensure that patients do not have to experience the harms of shortages and surpluses for the next 25years.