Newspaper article The Evening Standard (London, England)

Yes, Darzi's Polyclinics Could Work in London; Private Passion: Under Lord Darzi's Plans Many of the New Polyclinics Would Be Run by Commercial Contractors Rather Than the NHS Strain: Trinny Woodall and Johnny Elichaoff

Newspaper article The Evening Standard (London, England)

Yes, Darzi's Polyclinics Could Work in London; Private Passion: Under Lord Darzi's Plans Many of the New Polyclinics Would Be Run by Commercial Contractors Rather Than the NHS Strain: Trinny Woodall and Johnny Elichaoff

Article excerpt

Byline: MARK PORTER

HEALTH minister Lord Darzi's proposal to close smaller GP surgeries inthe capital and replace them with more than 150 new polyclinics offeringeverything from blood tests and minor surgery to dentistry and physiotherapyhas doctorsboth consultants and GPsup in arms. But what does it mean for you the patient? I have mixed feelingsabout the initiative, but if polyclinics are going to work anywhere then itwill be in densely populated areas like London where high property prices andthe resulting pressure on space mean that many existing GPs' surgeries arecramped and unsuitable for purpose.

On the plus side the new clinics should provide your family with a onestop shopfor most of your healthcare needs in a smart, clean, purpose-built environment.They are also likely to stay open for longer (8am-8pm) which should helpimprove access, particularly for people who work some distance from where theylive and for whom a routine smear test or a blood pressure check oftennecessitates half a day off work.

But if you need an urgent appointment access could actually be worse.

You may be lucky and live next door to a polyclinic but not everyone will andmost patients are going to have to travel further to see their GP.

I can't imagine parents being too keen on the idea of having to jump on a buswith a vomiting child, or a student having to walk an extra mile with arumbling appendix, or the elderly couple needing to book an even more expensivecab ride.

The real problem, however, is who you get to see when you arrive at the newsuper-surgery. It is very likely that many of the contracts to run thesepolyclinics will be awarded to private companies, raising concerns that theservice will be impersonal and patients will rarely get to see the same doctortwice, let alone a doctor they know or who knows them.

Continuity of care is one of the basic tenets of good primary care. We don'talways achieve it, but doctors entering the speciality quickly learn that it ispossible to give a higher standard of care to patients who they know well andto those who they can keep an eye on through regular follow-up. And the morecomplicated the patient's condition, the greater that advantage.

Or, to put it another way, seeing the doctor of your choice, or the same GPmore than twice in a row, won't matter a jot if you have an in-growing toenail,but it could literally mean the difference between life and death if you have acough that is getting worse not better, or when the diarrhoea has been going onfor weeks rather than days.

Both entirely innocent symptoms in many cases, but occasionally the only signof sinister underlying illnesses such as cancer.

Of course, private companies can employ loyal local staff too, but even thebest have turnover rates that are significantly higher than your average NHS GPpractice, where doctors often spend 35 years looking after the same group ofpatients. …

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