Polyclinics To Replace Single GP Surgeries Condemned By Health Groups, UK

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Main Category: Primary Care / General Practice
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Article Date: 16 Feb 2008 - 12:00 PDT

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Lord Darzi, Health Minister, who has been tasked by Gordon Brown to reform the NHS, would like to reorganize the English GP system. He favours larger polyclinics, which would replace current single GP practices. The polyclinics would offer specialist services and would be run by several doctors and health care professionals.

According to the British Medical Association, the polyclinic route would undermine the continuity of patient care - it could waste hundreds of millions of pounds and damage the GP system.

In a BBC Breakfast programme interview, Lord Darzi stressed that the sole GP practice is a thing of the past. Even though most people like their GP, he warns that an overhaul is coming. Patients' needs would be better served by polyclinics, Darzi added, which would have GPs plus other medical services generally only available in hospitals.

Darzi said to the BBC "I have no doubt in the future we are going to see a critical mass of general practitioners working together, rather than what we used to see in the past which were practices with a single-handed clinician." If the plan goes ahead, it could start with a 150 polyclinic project throughout the country.

Richard Vautrey, Deputy Chairman, British Medical Association's GP committee, said "This is a government plan that is potentially going to waste hundreds of millions of pounds of scarce NHS resources, creating very large health centres that many areas of the country simply don't need or want." He added that this could attract outside competition for NHS work from large multinational corporations. "They are effectively going to be looking for the cheapest bidder, who is going to run these health centres. What is going to happen is a duplication of services that won't necessarily meet patients' needs…. One of the other chief concerns about the polyclinic plan is the way the it will undermine the role of the generalised GP who can see any patient who walks through the door. One of Lord Darzi's other plans is that these centres would have a greater degree of specialists - for childcare, for women's problems. That actually starts to undermine the generalised role of the GP and means the GP can no longer see just about anyone who walks in the door and provide a holistic, generalised service that patients really value."

Dr. Vautrey says the polyclinic proposal may be OK for London, but not for less densely populated areas. He also felt that Darzi may be trying to re-invent the wheel in his own way - GPs have already been moving towards larger practices, longer opening hours, and are offering more services as a result.

If other countries are anything to go by, such as the USA, the polyclinic model may drive up costs as the number of tests carried out on each patient rises significantly. Dr. Vautrey explained that when a patient comes in with undifferentiated symptoms it is crucial that he/she is seen by somebody who can look at the whole picture, rather than focus entirely on one small area of the patient's body.

Lord Darzi of Denham KBE

Written by - Christian Nordqvist
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