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Polyclinic - a dirty word

It is 11 months since the Healthcare for London report first laid down proposals for polyclinics, and in some ways we are still no clearer about what they will mean for GPs and patients.

It is 11 months since the Healthcare for London report first laid down proposals for polyclinics, and in some ways we are still no clearer about what they will mean for GPs and patients.

Indeed, leading academics told a debate held by Civitas last week that they remained unsure what a polyclinic even was.

It doesn't help that at least three models have fallen under the polyclinic umbrella. Most familiar is the merged polyclinic – a straightforward super-surgery of 25 doctors and a variety of specialist services.

Then there is the hub-and-spoke polyclinic – a model being adopted widely in London – with one large surgery as hub and standard-sized practices as spokes.

And there are the GP-led health centres every PCT is getting, which are medium-sized with a heavy walk-in focus.

Initially, ministers applied the term polyclinic to all three, but now it's a dirty word we are told only the merged model counts.

This strategy aims to deflect criticism with obfuscation, and to describe polyclinics in such anodyne terms that even the most fervent critics run out of steam.

At last week's debate, proponents even questioned whether hub-and-spoke polyclinics were a new idea at all, suggesting they were really no different from groups of practices that chose to co-operate.

Unanswered question

Partly the confusion reflects a key unanswered question, over whether GPs working in polyclinics get to keep their current contracts.

But as the terminology gets more vague, the reality becomes more sinister and concrete.

As Pulse revealed last week, hundreds of surgeries are to close across London, in areas with hub-and-spoke and merged polyclinics alike.

Except, of course, that closure is another dirty word.

As Haringey PCT insists in a letter to Pulse this week: ‘This is not about closing surgeries... it's about reducing the number of locations from which primary care is provided.'

This is becoming a war of weasel words.

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