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Wednesday 20th June 2018

What is wrong with polyclinics?

12th June 2008

Dr Keith Hopcroft, a GP from Essex, writes in The Times about why the subject of polyclinics has provoked such an outcry amongst GPs.


The introduction of polyclinics can be likened to a "spectator sport", as it involves a fierce fight between MPs and health professionals.

GPs have said that the government is trying to implement poorly thought out ideas that will prove to be unsuccessful; while MPs have argued that doctors are "acting like prima donnas".

Put simply, the argument is based on Lord Darzi's suggestion that new surgeries - known as polyclinics - be put into place to improve patient care.

The government has put its weight behind the proposal and is interested in putting polyclincs in place throughout the country.

Why have doctors objected to the idea, when they are touted as offering "shiny new facilities, extended opening hours, multiple services under one roof"?

One major problem is the fact that extended opening hours only really benefit working people who need an appointment that will fit their schedules.

However, the people who use the service most often - older people, people with children, those with chronic conditions - need to have a surgery near to them.

Building a central polyclinic will be of "little use" to people who are unable to travel longer to get to it.

An additional problem is the "lack of continuity". A patient may not be able to see the same staff and the doctor-patient relationship will be compromised.

Polyclinics will make it difficult for GPs to ensure that patient care remains at the fore.

MPs have argued that doctors' objections come from the fact that they are part of a working culture which resists changes.

It is important the Department of Health asks why the medical profession - supported by the BMA, the Royal College of General Practitioners, the King's Fund and our patients - are "sceptical".

The reaction is, in part, "change fatigue". GPs are fed up that they are being tasked with yet another series of reforms. Doctors are still burnt from the government's overly harsh treatment of them over extended opening hours.

We are worried that the polyclinic proposal will turn out to be a flash in the pan - an idea which panders "to those with plenty of health wants but few genuine health needs".

Our strongest objection is that patient care will suffer through the loss of personal care. The development of polyclinics "is perceived as a threat to the heart and soul of general practice".

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