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At the heart of general practice since 1960

Darzi's polyclinics were a solution for London forced on us all

Your online map of the registration rates at different Darzi centres across England illustrates the essential flaw in the whole polyclinic project ('Darzi centres set to miss patient registration targets').

Lord Darzi's concept was a valid solution to problems in London (or parts of London), where the capacity and quality of general practice are limited and where development using the traditional practice model would never have been the solution.

Lord Darzi's mistake was to extrapolate this nationwide into a one-size-fits-all solution. Macro solutions do not suit primary care.

The logistical problems of general practice can only be solved by bespoke local solutions that deal with local issues. That's what the rhetoric about a 'primary care-led NHS' was supposed to be about - and would have been about if the Government had given the original GP-led PCTs enough time and resources to address the issues. What a missed opportunity.

From Dr Arnold Zermansky, Leeds

What the target-setters for Darzi centres' overestimated was their own self-importance, fuelled with the patronising politicians' mantra of 'we know best'.

Is anyone even remotely surprised that this initiative, like almost every other initiative, has been a dismal failure? These places fragment and disintegrate care, behaving like improvised explosive devices rather than smart bombs, leaving doctors to pick up the pieces after the politicians ruined what was a well functioning system (albeit one that needed some tweaks).

The problem now is that there is no going back on the demand generated by the patient choice agenda, unless charges are instituted at the point of use.

From Dr Dermot Ryan, Loughborough, Leicestershire

Lord Darzi's network of GP-led health centres was always a solution to a London problem unnecessarily imposed on the rest of England.

Part of me wants to smugly say 'I told you so', but another part is infuriated that through the total absence of local consultation millions of pounds of NHS money has been wasted.

This is a gross waste of public money and somebody needs to be called to account for it.

It is galling that almost all areas of the NHS are being squeezed while those at the top are treating the health service's funds in a cavalier manner.

We have perfectly adequate walk-in and out-of-hours services, so these centres should not be allowed to renegotiate their contracts.

The Department of Health should cut its losses by closing Darzi centres immediately and then holding a public inquiry on this gross misuse of public funds.

From Allan Stewart, practice manager, Wirral

Loxford polyclinic

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