This new policy paper, which follows up an interim report published in 2002, aims to take a fresh look at the issues facing planners, policy makers and managers responsible for maintaining and developing the health care workforces in London, and to tease out some of the opportunities, as well as the challenges facing them. Particular challenges are to provide effective health care in a city with a rising population, with many diverse communities and standards of living. A key message is that it is better to work with the particular dynamics of the London labour market, than to try and change them.