NHS boss signals death of 'crappy' GP practices

Ruth Carnall, head of NHS London, is masterminding an overhaul of healthcare in London including the introduction of "supersurgeries".

The plan is for these to be run by a team of GPs offering out-of-hours care to patients. But more than a million NHS patients have already signed a petition against the proposals.

In an interview with the Evening Standard, Ms Carnall said: "We're not forcing GPs to leave. But can singlehanded practice provide the range of modern primary care and other services? The answer is 'No.' What isn't possible is the single-handed GP operating out of his front room with a family friend or wife doing reception and no visible practice nurse.

"The ones which are going to close are the ones in crappy end-of-terrace houses where you can't park, get up the stairs or get a pram through the front door.

Many premises are wholly indequate. Why would we want to invest in those?"

Her remarks provoked outrage from the British Medical Association which is opposing plans for 150 polyclinics across London.

Laurence Buckman, chairman of the BMA's GP committee, said: "As London's health chief you have to be careful if you use words like 'crappy'. These practices are popular with all races and religions because they provide continuity which larger practices don't. But London PCTs have starved them of funds. You don't judge a practice by the its building but by patient satisfaction."

On Monday, the Government launches its blueprint for the future of the NHS. Health minister Lord Darzi will unveil the most sweeping reforms for 60 years.

The Government says the changes, including GP-led rural health centres and dedicated stroke centres, will enable different health trusts to tackle their own problems.

But critics have warned this could reinforce existing postcode lotteries and create a fragmented NHS.

The BMA will table a motion at its conference next month warning that Lord Darzi's plans are "flawed" and will undermine the ability of London to respond to terror attacks.

All 31 London health trusts have submitted plans for supersurgeries which are central to London's health reforms.

The Standard can reveal that health chiefs have already given the green light for the first of these.

The clinic in Redbridge, north-east London, is expected to open this year.

University College Hospital London has also put in a bid for a polyclinic.

Priority for the new surgeries will be given to London's most deprived areas.

Ms Carnall said: "The plans are not perfect and there are controversial aspects. But polyclinics were developed in London for London by people in London."

She also revealed that supersurgeries could provide a return to home visits for the most vulnerable patients.