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Plans for London NHS 'may not be best for patients'
Sophie Goodchild, Health Editor20.03.08
A leading think tank today attacked flagship government reforms for health services in London.
Health bosses predict radical plans such as replacing GPs' surgeries with larger "polyclinics" will bring £1.3 billion in savings.
But a report by the inf luential research charity the King's Fund warns these costings are unreliable. Its investigation also reveals a lack of evidence to support the benefits of polyclinics.
Polyclinics are a key part of the 10-year blueprint drawn up by health minister Lord Darzi. His vision is for the replacement of traditional GP surgeries with 150 polyclinics, where groups of doctors offer everything from X-rays to operations.
General hospitals will also make way for specialist centres and three major trauma units will specialise in multiple injuries.
But the King's Fund raises concerns that these measures are not necessarily best for patients. Its report says the evidence for shifting GP services to polyclinics is "weak" and that improvements in quality cannot be "assumed".
Its experts say larger practices do not guarantee better care for patients and the short-term costs of relocating GPs to polyclinics would be "expensive".
Niall Dickson, the fund's chief executive, told the Standard any changes must be based on the quality of patient care and access.
He said: "In some areas the evidence is less strong and there is a need for some caution, such as moving some GPs into much larger polyclinics. There may well be a case for creating some new facilities with a wider range of services, including diagnostic procedures, outpatient clinics and minor surgery - interventions now mostly carried out in hospitals.
"But any such plans should be evaluated on a case by case basis. We need to ensure the benefits of moving some outpatient appointments out of hospital is not outweighed by making patients travel further to see their GP for a routine appointment."
The fund does back proposals in the Darzi plan including the need for fewer and more specialised centres for stroke care and trauma. It also supports measures to provide better housing and employment support to improve mental health care.
Mr Dickinson added: "It is vital NHS London keeps to its promise to engage with staff and Londoners over any plans for reform."
Reader views (3)
It is CLEAR that our New Labour government simply do not care what is best for patients just as long as they get to keep their Jags, colossal salaries, guaranteed pensions, benefits and generous expenses!
It's about enough to make you sick! Ooops! That would be too dangerous under this present New Labour regime as you might actually have to go to hospital!
- Fraser, Telford Park
Switching from GPs to Polyclinics will destroy continuity of care, which is what a sick person really needs. Even within the same surgery there can be disaster when Doctor (1) fails to record properly what ails the patient and then Doctor (2) pops up with his/her own ideas.
Secondly, why are Polyclinics being proposed when others, like Women's Health Clinics, are losing their funding?
- Maureen, UK
The government is not going to listen to patients or GPs full stop. Other than to create a bullying arena of suspicion for both parties. Choice is needed,I would willingly chain myself along with others to my new up to date surgery to protect it at all costs. However, some little left alone rural pockets, well known to the HCC and DoH need something new,in order to provide that choice for families forced to bypass existing services, and driving miles or using eroded public transport to find out of hours, walk ins and reluctantly casualty. Who has the guts to challenge executive careers,in some cases with its cozy, covering up and salary guarding culture? If a community GP service regardless of size is efficient and working,leave it be, and get those spin merchants in the DoH to earn their salaries and fish out those sections within communities not doing the public or their medically trained colleagues any favours in terms of poor care, leaking funds and widespread stressful misery. Complaints needs to be handled as openly as praise. The GP salary is not the issue here,its lack of respect for the public and large groups of working people making the best of living in an expensive, increasingly badly run country. Labour does not look after its hard won voters, and does not respond to feedback.
- Maryfoordbrown, Suffolk Coastal
