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When is a consultation not a consultation? When it's on polyclinics

An interesting comment piece in the Guardian today tackling a question we’ve covered repeatedly in Pulse – when is a consultation not a consultation?

By Steve Nowottny

An interesting comment piece in the Guardian today tackling a question we've covered repeatedly in Pulse – when is a consultation not a consultation?

Towards the end of a devastating deconstruction of Hazel Blears' voting record, of all things, George Monbiot lists a series of consultations in which, as he puts it, the Government did not want to ‘leave anything to chance.' And – it may not surprise you to know - the consultations held on polyclinics come in for particular criticism.

Monbiot (who has covered the polyclinic issue previously) writes:

'As Dr Tony Stanton of the Londonwide Local Medical Committees has pointed out, "a week before a £1m consultation on polyclinics and hospitals by NHS London closed, London's 31 primary care trusts were issued with instructions on setting up polyclinic pilots and GP-led health centres".

Consultations elsewhere claimed that there was no need to discuss whether or not new health centres were required, as the principle had already been established through "extensive national level consultation exercises". But no such exercises had taken place; just a handful of citizens' juries engaging a total of a thousand selected people and steered by government ministers. Those who weren't chosen had no say.'

Here at Pulse we've covered the failure to genuinely consult on polyclinics before, in excruciating detail. We had the two north London trusts who presented plans for the capital's first polyclinic before the close of Healthcare for London's consultation (March 2008). Then it emerged that PCT consultations were not only failing to ask patients whether they wanted a GP-led health centre, they weren't even giving them a say on where it should be built (April 2008).

Enquiries made under the Freedom of Information Act revealed that half of England's PCTs had decided not to hold any formal consultation at all on the plans (June 2008). And then it was back to those two north London trusts who, it emerged, not only planned the capital's first polyclinic while consultation was still ongoing, but also met with private providers including Virgin Healthcare to discuss how they might run it (July 2008).

So for most Pulse readers, Monbiot may be preaching to the choir. But beyond increasing disillusionment with politicians, there is a specific danger posed by consultations which don't genuinely listen to the people they claim to consult.

Not all consultations are equal. Last December, for example, the Department of Health backtracked on plans to change the rules of entry for dispensing practices – and in doing so, ministers credited ‘the strength of responses we have received on the various options'.

We currently await the outcome of consultations on the secondary uses of patient data and the future of the QOF. Hopefully lots of GPs will have responded, and collectively will have made the voice of the profession heard. But if they didn't bother, assuming the outcome was a foregone conclusion – well, those polyclinic 'consultations' might have had something to do with it.

When is a consultation not a consultation? When it's on polyclinics Recent posts


What would you ask Alan Johnson February 05
Choose and Book: we told you so February 04
Is the straight white male GP really an endangered species? February 02
Preparing for power 30 January
Profits drop not the only story from GP survey January 29
Choose and Book: Two steps back, one step forward January 26
Lord Darzi's secret meeting with the private sector January 22
The best GP job in the world? January 21
Can Barack Obama revive general practice? January 20
Will polyclinic decisions bear closer scrutiny? January 19
Our GP insider's evening at number 10 January 16
'The UK's most improved GPs' How is that exactly? January 14
So who will be running those polyclinics? January 14

There is a specific danger posed by consultations which don't genuinely listen to the people they claim to consult.

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