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Polyclinic consultation branded a ‘sham’ as trusts go ahead

By Gareth Iacobucci

The Government's consultation over proposals to shift thousands of GPs into polyclinics has been condemned as a ‘sham', as PCTs forge ahead with plans to close down hundreds of smaller surgeries.

PCTs in London have begun to issue the first large-scale notices of the requirement to move into polyclinics, before the consultation on Lord Ara Darzi's plans has even been formally launched.

Unease over the lightning pace at which PCTs are moving to implement the proposals came as Lord Darzi signalled to MPs on the health select committee that he sees polyclinics as a key part of his vision for the NHS across the country. He said they were already running successfully in more than 100 sites outside the capital.

The BMA held an emergency meeting last week at which members condemned the aggressive moves to implement the polyclinics policy already taking place in London.

Dr Chaand Nagpaul, GPC negotiator and a GP in Stanmore, Middlesex, told the meeting: ‘PCTs are not behaving as if it's a consultation, and are acting as if they have to implement it.'

Haringey PCT is among those pressing ahead with plans, even though the polyclinic consultation does not begin until the end of November.

It has relabelled plans for six new supersurgeries, which predated Lord Darzi's review, as polyclinics and warned it will be willing to withdraw funding from GPs if they resist.

James Slater, director of performance and primary care at Haringey PCT, said at least half of its practices ‘fall below minimum building standards' and under its plans would ‘need to demonstrate how patients will have access to the same level and quality of services as at the new polyclinics' – or have their funding removed.

A spokesperson for Enfield PCT, where plans are under way to open five polyclinics, admitted it would also consider withdrawing funding from smaller surgeries that did not fit into its plans.

Dr Stewart Drage, secretary of Londonwide LMCs, warned polyclinics were ‘being driven with a strong enthusiasm, which suggests everyone's expected to follow this anyway'.

He added: ‘That's of great concern to my colleagues, who feel this is done and dusted, and the consultation feels a bit like a sham.'

But Sir Cyril Chantler, chair of the clinical advisory group of the Darzi review and chair of the King's Fund, told the BMA meeting: ‘If you think maintaining the status quo will do, I think you're wrong.'

Lord Darzi defends his polyclinic ‘vision statement'

Lord Darzi denied last week that polyclinics were his ‘favourite word'. But he told the Commons health select committee the concept had ‘captured the imagination of Londoners'.
Moreover, he admitted for the first time that polyclinics were being rolled out nationally, despite claiming the idea was ‘a vision statement, not a business model'.
‘There are 105 polyclinics outside London working extremely well,' he told MPs.
That contrasts with his comments in July at the launch of the Healthcare for London report. Back then, examples of polyclinics in the UK were in short supply, and he said the NHS would ‘have to look abroad' for inspiration.

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