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Media Archive 2008
Survey On Polyclinics And The Future of Family Doctors
NAPC has a membership of around 4,000 practices from which volunteers provide a rapid response to topical issues by joining a syndicated e-mail system designed to produce comments/data and opinion of subject of the day affecting healthcare and healthcare related matters.
The respondents are based throughout the NHS for a rounded and well balance view of events, and include GPs, other clinicians, PCT and practice managers and others working in and with primary care.
The process is to pose a question and invite responses. The answers to the questions are collated, graduated, evaluated into a unique snapshot of opinion, events, developments and trends in primary care.
In this case, on 22 January 2008 respondents were asked to respond to the question: ‘Do Polyclinics mean the end of family doctors?’
A summary of the responses is set out below, some of them impassioned. The comments were made in the wake of the press reports, this week, that the BMA was preparing to advise GPs to withdraw from the NHS. Interestingly, the majority of practices (75%) considered that general practice, as it currently operates, was facing its demise. Two particular recurring themes from both those who responded in the affirmative and in the negative were the inappropriateness of the polyclinic model for rural populations and the loss of continuity of care, particularly in the management of chronic disease. The most thought-provoking compared the future of family medicine with the current state of NHS dentistry.
„X If they flourish, we shall be consulting in office blocks and doing shifts. There will be no practice lists and patients will no longer have a GP they know. Patients will not longer be able to expect the doctor to know them, empathise with them, understand where they live, know their extended family and associated health and social problems, remember the good times and the bad, treat them like a person and a friend’. ¡K¡K.’ 15 years ago the dental service in this country was very good – today 7.5 million people don’t have a dentist and most of the rest pay for it and still pay national insurance contribution. I work in a council estate where most children have never seen a dentist – where they regularly come for antibiotics for abscesses, where we are now seeing kids with their teeth falling out and when they eventually get to a dentist all that can be done is extractions. We are now moving back to the old days of full dentures in young adults – great progress for a supposedly modern Western country. SHAME ON YOU Gordon Brown and your disgrace Labour Party. They are now doing the same with General Practice and the English public (and I say English because life seems to be different in Scotland) needs to wake up to this government’.
„X Training of GPs for the future will certainly suffer and continuity of care (removing their choice) if they only ever see a succession of different faces.
„X It is the beginning of the end, despite the rest of the world envying out primary care provision.
„X Patients may have better access but at the price of poorer standards, which is the ultimate agenda of Gordon Brown, as it is presumed it will save money.
„X The government will be sorry.
„X If the polyclinics are not structured carefully, the family doctor may be extinct in five years. The patient needs to be considered here and keeping the services close to the patient is important.
„X Patients may have embraced the Polish plumbers, but have rejected the Polish and Hungarian out of hours doctors and crowd the surgeries when they reopen. The same thing will happen with polyclinics if regular GPs are excluded from providing primary care medicine.
„X In places they died years ago.
„X This is fast moving towards the end of the NHS and private medicine. It is a shame millions of pounds have been wasted and continue to be wasted on political gimmicks, which duplicate or triplicate the same service.
„X Yes , if they ever put enough money into it, although there is room for niche surgeries that some prefer.
„X There is currently a move within our PCT (Harlow) to locate a new health centre in our locality which is planned to open 8am – 8pm, 7 days a week, with all relevant services and taking on registered patients. There is no such clinical need for this centre as the areas is already well-doctored. The centre will certainly mean that practices in our locality will suffer a decrease in list sizes and create an unstable situation.
„X The questions which arise are: ‘who will be responsible for continuity of care? How will the holistic approach to the whole family be affected and how much say will the individual patient have over care, or will it be decided by market forces?’
Only a 25% of respondents thought that General Practice would continue to provide a family doctor service. Comments included:
„X Some large surgeries retain good continuity of care.
„X The area will denote where family GP practices remain. Polyclinics sound good on paper but there are many areas where they will not work, where populations are small.
„X Polyclinics may work in the US, but here in the UK we need a personal touch and the NHS should be kept out of politics. Patients prefer a super, friendly, confidential, continuity of care, with lifelong records, surgery.
„X It is another ill thought through initiative designed to attract headlines and votes. What is a polyclinic other than a buzzword. The closest to what describes it is the district general hospital. I despair of the so-called leaders at the top of the NHS.
„X Patients won’t like them for logistical and personal care reasons. They will oppose them in public forums and to their MPs. They might work in London, but not here (Wirral). Polyclinics will undoubtedly create an impersonal service due to its sheer size and potential salaried GP arrangements.
„X May threaten single-handed practices but not others.
Mike Ramsden, Chief Executive of the Association, commented: ‘This snapshot of responses to NAPC’s rapid response survey throws up a number of issues of major significance for the future of primary care and the health of the population’.
‘The comparison’, he went on, ‘with the demise of NHS dental services is concerning and has considerable weight’.
For further information contact Mike Ramsden or Dr James Kingsland
About National Association of Primary Care:
The National Association of Primary Care (NAPC) is a non-political, non-profit-making organisation representing and supporting the interests of all its members, both individuals and organisations working in or with primary care. It also offers support through associate membership to those bodies, which provide services to primary care or have other health-related interests.
Mr Mike Ramsden, NAPC CEO: 020 7636 7229
Dr James Kingsland, NAPC Chairman: 07887 894 124
Mr Roy Lilley, NAPC Press Adviser: 07831 432 111