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Polyclinics, McKinsey’s – I’ve heard it all before

By Richard Hoey

Nothing is ever new in the world of primary care policy, as a trawl through Pulse's 50 years of archive issues makes only too plain

I'm increasingly of the opinion that in the world of primary care policy, there is no such thing as a new idea.

There are just ideas that were proposed, and roundly rejected, long enough ago that they seem new to the latest batch of politicians.

Employing McKinsey to advise on NHS efficiencies? Social Services minister Keith Joseph got their first, in 1971.

Language tests for foreign doctors? The BMA was calling for them all the way back in 1969.

And as for polyclinics… they pop up with disturbing regularity throughout the history of general practice, going back at least 35 years.

I know this because I have been trawling through the Pulse archives over the last few days, in preparation for our 50th anniversary issue, which is out next week.

Some things really do never change. The Department of Health has just overruled the pay review body on GP pay - and it was doing exactly the same thing back in 1970.

The RCGP is currently fuming after its call for five-year training for GPs was rejected by Medical Education England… but then its calls for five-year training have been getting rejected at least since the 1970s.

Nor are calls for a wholly salaried profession, or for a greater focus on health prevention, or threats to quit the NHS, anything new.

If there is one thing that has changed over the years, it is a growing commitment among most parts of the political spectrum to a centrally funded NHS.

Back in the late 1970s, when the NHS celebrated its 30th birthday, not everyone joined in. Conservative politicians, and some members of the BMA, openly questioned whether a solely tax-funded system could ever survive another 30 years.

It did, of course. But the challenges to NHS finances are if anything stronger than ever, and it's perfectly feasible that the questions will resurface.

If the health service is going to survive and thrive, it's going to need something more than the same old, recycled ideas.

By Richard Hoey, Pulse editor