Shag pile and pot plants do not a surgery make, says Jobbing Doctor.
This week we are seeing, in our little corner of the NHS, the opening of a shiny new building. It is a manifestation of New Labour's investment in primary care. It is huge. It is innovative. It is expensive (£20 million pounds). It is also pretty irrelevant.
Some people might think that all the Jobbing Doctor does is moan, but I do like to give praise where it is due.
This modern colossus will have many of the attached staff based there: district nurses, chiropody, speech therapy, many important people will be based there. It looks really good as a building design, and it is right next to a new road.
This is where New Labour have tried to develop and enhance local services. Certainly older buildings, especially some of the health centres from the 1960s have needed to be upgraded. There are even two local practices that have been incorporated into this brand new palace.
But not mine. Never.
Herein lies a problem. My manager colleagues ask me why my practice is not interested. They cannot understand why we should not want to be incorporated into a building where all the ancillary services and administration are sited.
If the truth is told, firstly they never asked. If we had been approached in the planning stage of this project four years ago, we could have been incorporated into the programme, and indeed as the only training and teaching practice in the locality, we should have been the premium target to get involved. But they never asked.
Secondly, we would not have gone into this project. One of the reasons is that we have seen what happened to another practice who planned to shut down two surgeries (both in converted detached houses) and shift all of their work into another of these huge builds.
They completely lost their identity, and weren't even able to put any signs outside of their rooms. From the outside, nobody knew they were there. They had to resort to putting big signs on paper in the windows. They quickly reopened their branch surgery, because of patients' pressure.
Shag pile and pot plants do not a surgery make.
So two practices next door to us (literally) will move over this weekend. Normally, when a practice moves to new premises they will attract an increased number of patients. In this case this will not happen.
It is about making a practice patient friendly. They will lose their own personal receptionists, insofar as patients will have to go through the main reception prior to getting to the practice. A practice is often judged by the quality of the front-line reception.
There is also not adequate parking so their patients will be asked to park in a supermarket car park across a busy dual-carriageway road (with pedestrian lights), for which they will have to pay and display.
We expect there to be a drift towards our old-fashioned style of practice (purpose-built premises with good free car parking), and I told one of the doctors in one of the other practices that they would be vulnerable to patients signing on with us.
He agreed with me, but in a rather doleful comment said that they had no alternative as they were in PCT-rented premises, anyway.
So, it is increasingly looking like the vast majority of the local primary care will still take place in Jobbing Doctor towers. The neighbouring practices will be swallowed up in the palace of offices.
£20 million will be spent on premises that will cover less than half our numbers.
A plush white elephant.
The Jobbing Doctor is a general practitioner in a deprived urban area of EnglandJobbing Doctor