This report looks extensively at changes in the activities of GPs from 1998 to 2008 in the light of numerous government initiatives and changes in the GP workforce and in the population. It shows that GP activity generally correlates well with health policy initiatives and clinical guidelines, notably with Type 2 diabetes and the control of asthma and high blood cholesterol levels. In some areas, however, there is less evidence of an effect so far. The report also raises some potential concerns about the costs from the continued rapid growth in orders for pathology testing and the overall challenge for the GP workforce in dealing with an ageing population with complex needs. Edited by Britt H and Miller GC.