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Although the ethical decisions made in primary care are often as less dramatic than those in high-tech medicine ( 1 ) , their cumulative effect may be profound ( 2 ) , because of the vast number of health care encounters which take place in primary care , ( approximately 400.3 million in England in 2008 alone ( 3 , 4 ) ) .
 England
Please list all entity words in the text that fit the category. Output format is "word1, word2". 
Option: media, plant, vehicle, astronomical object, time, disease, animal, location, person, organization, mythical figure, food, biology, geographical phenomenon, instrument, event 
Text: {0} 
Answer:
 England