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Do we need two-tier family GP services?
THE idea of polyclinics -
large health surgeries
offering a wide range of
services and open at
weekends and on weekday
evenings - has much to commend
it, particularly for those
in work with busy lives.
Most people have experienced
difficulties in getting to see a
family doctor because many
GPs do not operate particularly
family-friendly hours. The Government
has asked GPs to open
later and at weekends, but
hardly surprisingly they have
not been very co-operative.
They have only recently negotiated
the current arrangements
involving out-of-hours cover,
which brought their working
hours down to sensible levels.
Given the Government offered
no financial incentive to GPs to
provide this additional service,
it hasn't got off the ground.
The polyclinic concept seems
like a way round this impasse.
If GPs do not offer the flexibility
required, the imposition of a
polyclinic would solve the
problem. That appears to be
the unstated thrust of the policy.
GPs are understandably worried.
A polyclinic in their midst
could undermine the service
they offer and make their practices
unviable. They would have
a choice of joining the roster of
18 or more doctors working at
the polyclinic, possibly run by a
private company, or find somewhere
else to practise.
The Government says this is
not so. It says the polyclinics
would be in addition to existing
GP services. The clinics would
supplement the existing network
of GP practices and not
replace them.
If that is so, it would seem to be
potentially very wasteful. The
last thing the NHS needs is duplication
of services. It would
be ironic indeed if polyclinics
mushroomed in communities
that have, by and large, lost
their community/cottage hospitals
in recent years.
In County Durham, the Easington
district has seemingly been
earmarked for the first polyclinic.
Quite how village-based
surgeries will work with a clinic
based in, say Peterlee, is not
clear. It is surely inevitable that
some would not survive and
patients in some of the most
disadvantaged areas would be
faced with longer journeys to
see a GP.
In Durham City, because of its
population mix, there may be
scope for a clinic to service
those elements of the population,
including students, who
may not use a family doctor.
But it is surely the case that the
more successful a polyclinic is,
the greater the threat it is to existing
practices, and to valuable
doctor-patient relationships
which may date back many
years.
The Government says this will
not happen. We are not so sure.
12:36pm Friday 20th June 2008
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CommentPosted by: DB, Durham on 9:16pm Sat 21 Jun 08
I think it's about time Doctors realised they were part of the service industry, and that it's not only the pensioners (who seem to fill every appointment slot, and no doubt will now expand their requirements to evenings and weekends) that need to see a doctor. I can't see why they feel threatened by polyclinics, is it because they will loose their wokring patients to something more flexible, and if they don't adapt they'll close? I think given their payrise recently they should be doing out of hours calls and opening at later times to accomodate those of us who work for a living and pay our tax, to pay them.
I think it's about time Doctors realised they were part of the service industry, and that it's not only the pensioners (who seem to fill every appointment slot, and no doubt will now expand their requirements to evenings and weekends) that need to see a doctor. I can't see why they feel threatened by polyclinics, is it because they will loose their wokring patients to something more flexible, and if they don't adapt they'll close? I think given their payrise recently they should be doing out of hours calls and opening at later times to accomodate those of us who work for a living and pay our tax, to pay them.
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