Polyclinics
Posted by Mark Todd, MP for South Derbyshire, at 20:57, Mon 30 June 2008:
The idea behind these clinics is that GPs work alongside a variety of health professionals, including nurses, pharmacists, dentists, social workers and hospital doctors, offering patients a level of integrated care unheard of in the current system.
These clinics will also be open 8am to 8pm seven days a week, and can be used by anyone - even those who are not registered there.
Lord Darzi, the health minister and a practising surgeon, is the key person behind these proposals. His interim report in the autumn called for 150 GP-led clinics to be set up across England.
But there are no concete plans yet. Primary Care Trusts are only carrying out their consultations about how services should look.
But there is already some opposition. The British Medical Association, for instance, has launched a campaign called 'Support your Surgery', with posters put up in GP practices across the country, including mine in Willington. Much of the anger centres on what is perceived to be the government dictating from the centre.
I think the proposals seem a reasonable approach to primary care in a city environment. They will increase the range of things that can be done locally without outpatient visits to hospitals (or even minor admissions). However I doubt their value in a more rural setting since, if they were to work, they would extend travel time to see a GP significantly. They could also reduce the contact with individual GPs which some patients value. I have to say I happily see all the GPs at my own practice – I don't choose one.
There are some other difficulties which are not to do with healthcare which may obstruct these proposals. The current model of primary care often involves GPs owning their own premises and deriving an income from the practice and from selling on the value of their partnership. A shared facility would change the way GPs plan their lives in financial and retirement terms. It is perhaps unhelpful that GPs don't set out their own interest in current arrangements - a GP practice is essentially a small business but one wouldn't guess that from the anxiety their spokesmen express about the possible involvement of companies in primary care through polyclinics.
So a balanced examination of the issues is needed. Imposition of a fixed model from the centre won't work but there are settings where a polyclinic would be very valuable.
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