A GP friend tells me that he is convinced that the NHS will be privatised by Labour. He tells me that the Governments intention is to set up 'Polyclinics'. On R4's Today programme Ara Darzi, a colorectal surgeon who has been raised to the peerage and made an undersecretary of state for health, stated that if a majority didn't want a polyclinic in their area they didn't have to have one. My GP friend tells me that was a complete lie, as he has seen the directive from the government to the Primary care Trust, telling them that they WILL set up a polyclinic and receive bids etc etc. A couple of links may be of interest:....... http://www.guardian.co.uk/commentisfree/2008/apr/29/nhs.health and ..... http://www.guardian.co.uk/commentisfree/2008/mar/11/nhs.health ... Would anybody care to comment?

David Your GP friend certainly have a point.There is a remarkable gap between the government’s rhetoric on local decision-making and its obsession with imposing models of care from the centre. On the one hand DOH is holding a consultation on the future of NHS services and on the other it has already asked all Primary Care Trusts (PCTs) to open at least one polyclinic in the near future .The government is imposing this centralised plan on to everyone whether they need it or not. I believe this will be a disaster for most patients in the longer term. The government is going to set up these polyclinics in competition directly with existing practices rather than supporting and developing them. This would result in duplication of services that won’t necessarily meet patients’ needs. They are going to lose their trusted health advisor and advocate.These proposals could fragment services and apply a damaging business culture to both hospital and primary care.Although primary and secondary care may be destabilised, polyclinics appear to be of great benefit to the private sector.Private firms are queuing up to spearhead Lord Darzi's drive for a polyclinic in each PCT.Firms including Serco, UnitedHealth and Assura each plan to take on dozens of the centres, employing salaried GPs directly or recruiting GPs in profit-sharing partnerships.The move will dramatically ramp up private provision in primary care, by as much as three-fold, and signals the beginning of a period of huge changes for general practice replacing time tested traditional general practice by Polyclinic model run by private companies for the benefit of shareholders . The plans for polyclinics across the UK are already well advanced. And although the Government has promised entrepreneurial GPs will get 'a level playing field' in the tendering process for the new clinics, leading companies are confident they will easily out-muscle GP practices. Polyclinics might be a solution for some communities, but particularly in rural areas access to a doctor could become a nightmare.Enormous, distant health centres with vast numbers of staff and doctors are the antithesis of personalised care.Professor Martin Roland of Manchester, who carried out an analysis of 30 demonstration sites that are being used to pave the way for the changes, rightly concluded that the current model of GP practices provided more choice and better access than polyclinics.He believes that while standards could vary widely, overall they were judged to provide better care than polyclinics.Additionally,the concept of Polyclinics totally ignores the needs of Public health so vital to maintain and promote the health of the nation rather than spending resources on the illness only.One could appeal to the good sense of Alan Johnson to once again carefully examine the merits of restructuring and replacing the Traditional General Practice model with failed model of Polyclinics elsewhere in Rastren Europe/North America.

Providing funding for new practices in deprived areas is a positive step and the local NHS must ensure the opportunity to bid for these services is made available on an equal and fair basis to existing GPs alongside commercial and other providers mentioned by the Alan Johnson. The GPs been the backbone of the NHS and in my view should be encouraged to expand their services.