June 19, 2008

Not What the Patient Ordered

By Rob Merrick

THE Government has taken away your post office, your local shop and your local police station - and now it's gunning for your family doctor.

That is the claim made by the Conservatives, who have joined forces with the British Medical Association to wage war on plans for so-called "polyclinics". These super-surgeries, bringing together up to 25 GPs under one roof, will gobble up your neighbourhood doctor, forcing you to travel much further for a check-up - or so the Tories claim.

But Health Secretary Alan Johnson compared such "lies" to the infamous Tory-BMA double act that once described the NHS as something out of Nazi Germany. So what is the truth?

The first point to make is that the existing setup badly needs shaking up because many GP practices are in the wrong places and open at the wrong hours.

Because GPs run private businesses, the NHS has always struggled to get them to open surgeries in the neediest areas. It is an easier life in the leafy suburbs. Add to that the GPs' success in brilliantly negotiating an enormous pay increase, while refusing to open up at hours to suit working people, and the need for change is clear.

In that light, the polyclinic proposal - open from 8am to 8pm, to any patient who walks in, offering tests and X-rays only available currently at a distant hospital - should be stunningly popular.

Furthermore, the department of health (DoH) has pledged [pounds]250m to ensure no existing GP practices will have to close. So what is the problem?

Well, first, the DoH appears to have admitted that patients will have to travel further to see a GP in London, where polyclinics are arriving first.

Second, it has insisted the new buildings will be "GP-led health centres" - not polyclinics - outside the capital, without explaining the distinction.

Third, the independent Kings Fund has said of the plan: "It will destabilise the system unnecessarily and seems to be an enormous waste of taxpayers' money."

And fourth there is the suspicion - no, certainty with this Government - that we are seeing the creeping privatisation of the NHS.

We are told most centres will be run by groups of GPs but, in London and Derby, GP surgeries have already been farmed out to big American health firms.

In London's Camden, the contract was handed to United Health. The company featured in Michael Moore's film Sicko - as part of a devastating indictment of healthcare failures across the pond.

I think the danger is that patients will enjoy extra services, but at the price of swapping their familiar GP for a faceless corporation.

What is certain is that the post office closure programme is poisonous for Labour, with widespread fury that a much-loved public service is now disappearing. Any suggestion that GPs are going the same way could mortally wound the Government at the next election. The stakes could not be higher.

GEORGE Bush was surprisingly articulate on his last visit to Westminster this week - at least compared to past car-crash press conferences, when he played the Texas village idiot to perfection.

But his speech did not contain this gem: "One of the things I will leave behind is a multilateralism to deal with tyrants so problems can be solved diplomatically."

They talk of little else in bombed-out Baghdad and Basra.

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