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Gold, incentives and meh

My polyclinic beats Darzi's hands down

Much has been written recently about the new polyclinics proposed by Lord Darzi. I felt it might help the discussion to describe the polyclinic where I work.

We are located in modern purpose-built premises conveniently located in the heart of our community. We ensure easy access for patients, who can see a doctor or nurse within 24 hours.

Appointments can be booked in person, by telephone and online.

Patients can, in addition, book an appointment a month in advance. There is very little waiting time on the appointments phone, and no automated voice system - we believe ill patients should be able to speak to a highly trained receptionist.

We have a range of health professionals working from the polyclinic. In addition to doctors, we have a nurse, a healthcare assistant, a health visitor, a midwife, several mental health workers, an addictions counsellor, a physiotherapist and a podiatrist.

Problems are dealt with holistically, taking into account psychosocial and spiritual problems, as well as physical ones.

We have an active patients' group which helps to steer the polyclinic and meets twice a year, we receive excellent administrative support from our dedicated team and we need very little input from the PCT.

Many GPs reading this may feel their surgeries seem to offer a similar service. And at this point, I must come clean and confess the description above is not for a polyclinic at all, but for a two-doctor dispensing GMS surgery, which has been running since 1947 - although the doctors and buildings have changed in that time.

My concern about polyclinics is that they will duplicate current services and take money from existing practices.

I believe passionately that the polyclinic model is badly thought through and risks damaging continuity of care.

It does, however, allow alternative providers to enter the health market and everyone suspects this is the true long-term objective of the Government's reforms.

The fact that polyclinics exist in the US is no endorsement. Am I alone in believing healthcare in the US has got it wrong?

Dr Julian Fester, Whitby, North Yorkshire

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