Super-clinics 'will be costly and offer worse patient care'

Creating scores of polyclinics – health centres housing GPs, surgeons and dentists – could actually make patient care worse, a report warned yesterday.

The 'one-stop shops' could mean patients have to travel further, according to the influential King's Fund foundation.

Despite providing a wider range of services, polyclinics are unlikely to ease pressure on NHS hospitals, it said.

They could be more costly and offer worse care.

The change has been recommended by health minister Lord Darzi, who is carrying out a review of the Health Service.

Up to 150 polyclinics are planned for England, with each responsible for up to 25 GPs and thousands of patients.

Health Secretary Alan Johnson insists these 'GP-run' health centres will not lead to a reduction in traditional family doctors.

But the Conservatives estimate that 1,700 GP surgeries – one in five – would be forced to close.

This would potentially mean patients having to travel further to reach their GPs, which could cause particular problems for the elderly and rural dwellers.

The King's Fund analysis of polyclinics concluded there could be 'significant risks for patient care' particularly if the introduction of such centres were poorly handled.

The report also stated there was no evidence that larger GP practices delivered better care than smaller ones. 'There is also evidence that quality may be decreased in certain cases,' the researchers said.

King's Fund chief executive Niall Dickson added: 'For some patients, access to diagnostic tests and other services – such as minor surgery – would improve under polyclinics but the impact would vary depending on how large and centralised the polyclinic would be.

'A major centralisation of GP services into polyclinics would make it more difficult for patients to visit their GP.

'This would be a major sacrifice given that primary care visits account for 90 per cent of all patient contact with the NHS.'

Dr Jonathan Fielden, chairman of the BMA's consultants committee, said the Government should 'dump the polyclinic plan'.

He added that it 'holds no water, has no benefit and no financial gain'.

Norman Lamb, Liberal Democrat health spokesman, said: 'This is a damning critique of the Government's shortsighted obsession with polyclinics.The case for polyclinics is highly questionable.

'Any decision to open a polyclinic must be made locally.'

A spokesman for the Department of Health said: 'We are not imposing super surgeries or polyclinics or replacing existing services. The 150 GP-led health centres will serve as an extra way to see a doctor.

'They will be open seven days a week from 8am-8pm and anyone will be able to walk in and see a doctor.'

One in five NHS trusts is still in debt and cutting patient services, according to a hard-hitting report by MPs.

Despite the NHS recording a surplus of £515million last year after heavy job cuts, 82 of the 372 trusts ended the year in deficit.

Edward Leigh of the Commons Public Accounts Committee praised the Department of Health for recording a surplus.

But he added: 'The headline figures mask some unwelcome evidence that the NHS is not yet travelling along the road to longterm financial health.'

FACTFILE: POLYCLINICS

• A polyclinic is a large health centre serving a population of 50,000 or more.
•  Services will include GP visits, diagnostic testing, minor surgery, dentistry and mental health care.
• Patients can make appointments or just walk in.
• NHS London says patients could have to walk for 1.5 miles, or take public transport.
• GPs available between 8am and 8pm, seven days a week.