Polyclinics threaten 600 GP practices, say Tories

More than 600 GP practices are under threat because of labour Government plans for "super surgeries" despite overwhelming public opposition to the proposals, according to the Tories.

Hundreds of family doctor surgeries across England have been identified by local health Trusts as being in the same catchment area as proposed new polyclinics.

The Conservatives have compiled the list of practices across the country, named in plans for polyclinics drawn up by Primary Care Trusts, which they say could be killed off by the scheme.

They said the list showed practices which could be forced to shut because they would lose patients to the new clinics if they went ahead and warned that the final figure is likely to be much higher as many Trusts are still compiling plans.

Doctors who found their name on the list would now be "even more concerned than they were already" about the possibility of closure, the British Medical Association (BMA) said.

But the labour Government insisted that there was no suggestion in the documents that any of the practices had been earmarked for closure.

Recently, more than 1.2 million patients signed a petition protesting against plans for polyclinics, which was delivered to Gordon Brown.

Doctors' leaders argue that the new surgeries will destroy the relationship between patients and their GP family doctor and force them to travel much further to see a doctor.

GPs are also worried that polyclinics could "cream off" younger, healthier patients who help to subsidise their practices to treat those with more complex medical problems.

But ministers insist that the clinics, which could house up to 25 GPs as well as extra services such as dentistry and minor surgery and will open during evenings and weekends, will provide a "world class" service.

The Tory research reveals that 608 practices in almost half of all Primary Care Trusts outside London -where ministers insist that the "GP led health centres" will be in addition to existing services - have already been listed as close to proposed new clinics.

If this were replicated across the rest of the country including the capital as many as 1,700 practices could be under threat.

The Tories said the implication was that polyclinics would threaten the viability of the practices listed, even if not all of them would be forced to shut.

Andrew Lansley, the Conservative health spokesman, said: "The Government needs to explain why these GP surgeries are being named if it's not because polyclinics pose a threat to the local doctor.

"It adds to the huge weight of evidence now building up that polyclinics are not the additional services as Gordon Brown has claimed. Patients and family doctors are right to be worried about losing a valued local service. It's time Labour faced up to their concerns and called a halt to their unpopular polyclinics scheme."

A spokesman for the BMA said that the publication of the list would worry GPs already concerned that their practices could shut.

He said: "We have always had concerns about the viability of practices that are close to these polyclinics.

"It is inevitable that they will lose resources because of the new development, even if they are not actually dragged into it.

"Ben Bradshaw [the Health Minister] has said that some patients won't have to deregister with their GP to use this service, but that is not really the point.

"There is only one pot of money and if it is all going into polyclinics then GP surgeries will have to cut back on services and many could be forced to close."

He added: "GPs who find themselves on this list will be even more concerned than they were already."

An official spokesman for Mr Bradshaw said: "There is no suggestion from any of those PCTs that these surgeries are marked for closure."

Within London, where ministers insist plans for polyclinics differ from the rest of the country, around 100 practices have already been already earmarked for closure, to make way for the new surgeries.

From:
Polyclinics-threaten-600-GP-practices%2C-say-Tories.html

A million patients battle against polyclinics

More than one million patients have signed a petition protesting against plans to close hundreds of GP practices to make way for polyclinics.

The signatures, collected by the British Medical Association (BMA) in just three weeks as part of its "Support Your Surgery" campaign, was presented to Gordon Brown at Downing Street.

The BMA is concerned that the new clinics will destroy the relationship between patients and their family doctor

The labour government cannot afford to ignore the level of patient concern over polyclinics, which have been dubbed "supersurgeries", doctors' leaders will say.

Ministers insist that the centres, designed to house up to 25 GPs under one roof along with other services such as minor surgery, will provide a better service for patients.

But the BMA claims they will destroy the relationship between patients and their family doctor and lead to more private companies running surgeries.

Analysis by the Tories suggests that 1,700 of the 8,700 GP practices in England could have to shut under the plans.

Around 100 GP practices in just eight PCTs in London, the first part of the country to roll out the policy, have already been earmarked for closure to make way for polyclinics.

Doctors will protest against the plans at the BMA's Local Medical Committees annual conference today, entitled "standing up for General Practice".

Dr Laurence Buckman, chairman of the BMA's GPs Committee, will tell GPs at the meeting that the petition "will deliver a stark message to the Prime Minister" about the true level of patient concern.

Dr Buckman will also say: "My message to Gordon Brown is this: Whatever you think of GPs, take note of what your electorate thinks. Work with us to improve the service, not against us, and ignore at your peril the wishes of the most important people in the NHS – the patients."

He will tell GPs : "If the government won't listen to you, their doctors, then surely it will listen to the 1.2 million men and women who call for a halt to the plans to promote the use of commercial companies in general practice.

"Voters don't want funding to move from GP practices to commercial companies who are accountable primarily to shareholders rather than patients. They want to be treated as patients, not customers."

The petition calls on ministers to "continue to support our existing NHS GP surgeries" and "improve services to patients by further investment in existing GP surgeries".

But Neil Bentley, from the Confederation of British Industry (CBI), accused doctors' leaders of "ostrich-like denial" and said that the plans would extend opening hours and increase the range of services offered to patients.

From:
A-million-patients-battle-against-polyclinics.html

Polyclinics will not improve care, consultants tell BMA

Six out of 10 consultants say polyclinics will not improve patient care and 83 per cent fear privatisation of the NHS is detrimental to patient care and the service overall.

The survey, carried out by the British Medical Association, says that over half of respondents say they are prevented from innovating to improve patient care and seven in 10 lack adequate resources to support their work. The policy of patients having a choice over where to have treatment was supported by 69 per cent of respondents.

The BMA Central Consultants and Specialists Committee (CCSC) commissioned this survey on consultant opinion to gather information about consultant members’ views on labour government health policies, how changes are affecting consultants ability to care for their patients and to work to their full potential as trained professionals.

Consultant member views were gathered to ensure that members’ views were represented in future discussions on these issues. and to inform the BMA’s evidence to the review body on doctors’ and dentists’ remuneration (DDRB).

Key findings of the survey
* A total of 1,587 complete responses were received with an overall response rate of 31.7 per cent.

* Only 7 per cent of respondents remain on the pre-2003 contract.

* The average number of PAs included in the job plans of respondents on a full time contract was 11.3. 60 per cent of all respondents stated that the number of PAs accurately reflected the level of direct clinical care undertaken. The average number of SPAs included in the job plans of respondents on a full-time contract was 2.5. 55 per cent of all respondents stated that the number of SPAs did not adequately reflect the work involved.

* The average number of hours worked per week for respondents on a full time contract was 50.73 with almost one in five working more than 55 hours a week.

* There was overwhelming support for further change to the CEA scheme to improve its ability to reward excellence and general support for all awards being made available locally.

* 85 per cent of respondents indicated that there was a process in their Trust for consulting with consultants on contractual and human resource (HR) matters. This was for the most part via the Local Negotiating committee or through the job planning and appraisal process.

* There was overwhelming support for the view that consultants should be leaders and innovators in clinical practice. 52 per cent of respondents believed that consultants were actually prevented from innovation in support of patient care.

* Two thirds (66 per cent) reported that the numbers should be expanded in their departments, 31 per cent reported they should remain the same. 78 per cent of respondents reporting affordability as the reason for their response that consultant numbers should remain the same.

* 70 per cent of respondents reported that they did not have adequate resources to support them in their roles as consultants. Of those respondents who reported they did not have adequate resources 63 per cent of responses from respondents reported lack of secretarial support, 48 per cent reporting a lack of IT and a further 48 per cent a lack of managerial support.

* 60 per cent of respondents disagreed or strongly disagreed that polyclinics would improve the quality of patient care and almost two in five disagreed or strongly disagreed that polyclinics would improve patient access to treatment.

* 73 per cent of respondents reported that the direction of government policy to expand use of the private sector was detrimental to patients and the service as a whole. 83 per cent of respondents reported that privatisation of the NHS would be detrimental to patients and the service as a whole.

From:
http://www.bma.org.uk/ap.nsf/Content/Surveyconsultantopinion08

NHS at 60- Labour no longer trusted on National Health Service

NHS at 60- On the eve of the NHS's sixtieth aniversary a new poll shows that Labour is no longer the party trusted to bring in the health reforms that are needed to safeguard the NHS for future generations.

Despite the billions Labour has poured into health, the YouGov poll shows that public satisfaction with the NHS is dropping. Barely one in five people believe the Labour party will deliver a better health service over the next ten years, the You Gov poll shows.

It comes on the day Gordon Brown is to publish Lord Darzi's package of reforms to overhaul the way the NHS is run.

The Prime Minister hopes the comprehensive review will transform Labour's fortunes and restore the party's reputation as guardians of the NHS on its 60th anniversary.

The results of the poll show he Tories have a clear lead on health policy with 31 per cent of people saying they would do a better job of running the health service, compared to 23 per cent who think Labour would deliver on the NHS.

The results of the latest poll confirm a shift in the political debate over health care, away from funding and towards improved management and organisation.

After years of above-inflation increases in health spending, most voters now believe the NHS has enough money. But they worry that the service has become bureaucratic and over-burdened with managers.

Sixty-nine per cent of people said reorganising the NHS is more important than spending more on it, up from 38 per cent in 1998. Only 24 per cent now want more spent on health, down from 59 per cent a decade ago.

Seventy-eight per cent of voters believe the NHS has too many managers.

And despite the billions Labour has poured into health, the new poll shows that public satisfaction with the NHS is dropping. In 1998, some 91 per cent of recent patients said they were happy with their treatment. That figure has now fallen to 81 per cent.

Some 44 per cent of people said they think "a great deal" of money is being wasted in the NHS. Another 38 per cent said a "fair amount" is wasted.

"David Cameron's unambiguous commitment to the National Health Service means a great deal to the public. They know that the NHS needs reform and that Labour have failed them on this crucial issue," said Andrew Lansley, the shadow health secretary.

"But they also know that Conservative reforms for healthcare will not threaten the security that comes with a health service available to all, based on need. This poll shows that the public, like staff across the NHS, are now willing and ready to trust the Conservatives with the stewardship of the NHS."

In the foreword to the Darzi report, the Prime Minister hails the document as the blueprint for a "once-in-a-generation" shake-up in the NHS.

The report will usher in the creation of "polyclinics" with several doctors and nurses to replace hundreds of GP surgeries in the biggest cities, despite opposition from patients and the

British Medical Association.

It also says that hospitals should publish death rates for dozens of conditions, allowing patients to make "informed choices" about where to get treatment.

Hospitals should offer more home births for mothers, and old and terminally-ill will get the right to chose to die at home instead of in hospital.

And a new NHS constitution will enshrine rights to confidentiality, control of patient records and a second medical opinion.

Mr Brown writes: "Lord Darzi's report is a tremendous opportunity to build an NHS which provides truly world-class services for all. It requires government to be serious about reform, committed to trusting front-line staff and ready to invest in new services and new ways of delivering services."

But Norman Lamb, the Liberal Democrat health spokesman said he feared the Darzi package would be vague and impractical. He said: "What does all this mean? Will patients be able to enforce their rights?"

And despite Mr Brown's bold claims for the review, there are doubts about whether Lord Darzi has been allowed to go far enough in drawing up his reform plans.

His report is not expect to deal with the controversial issue of "co-payment," where patients can pay extra to top-up NHS care with private provision. That omission has drawn accusations that the review is too limited to prepare the health service for the demands of the next century.

A separate opinion poll for Reform, a think-tank, has suggested that most doctors believe top-up payments should be introduced to the NHS.

The ComRes poll showed that 79 per cent of GPs believe patients should be able to top-up their NHS care with private treatment.

• YouGov polled 2,163 adults across Great Britain between June 23 and 25.

From:
Labour-no-longer-trusted-on-NHS-reforms.html

Polyclinics 'will hit most vulnerable'

Closing GP surgeries to replace them with "polyclinics" will hit the most vulnerable members of society and damage the fabric of local communities, David Cameron said.

The Tory leader warned that Labour's plans for health care could lead to the closure of one in five GP surgeries around the country.

Mr Cameron said local residents should have the final say on whether surgeries should be replaced and urged GPs to fight the changes, signing up to a petition opposing the planned reforms. Polyclinics, conceived by Lord Darzi, a health minister and consultant surgeon, will combine GP services with nursing and social care on one site.

The Government insists they will create more choice for patients and greater access to specialist care.

Opponents fear they will leave some patients with long journeys and destroy the personal relationship between patients and family doctors. In a speech to a health think-tank in London, Mr Cameron said amalgamating as many as 1,700 GP surgeries would damage the fabric of local communities.

He said: "Labour has already tried to bring about the end of the district general hospital. Now they are trying to abolish the family doctor service. Communities which have lost their post office, their local shops, their local police station, are going to lose their doctor."

People including the elderly, those with small children and those with long-term conditions would be worst affected, Mr Cameron said.

"Those are the people least able to get to a polyclinic, and least comfortable in a large impersonal institution. They like to rely on the doctor they know, at the end of their street, often in a building not much bigger than a house," he said. "They have a human relationship with their GP that they simply won't have with a member of staff at a polyclinic."

Instead of "imposing" the clinics on communities, Mr Cameron said ministers should make the changes subject to binding local consultation. He said: "Where they occur, they should occur naturally, as the voluntary combination of free agents, not as the latest structural reorganisation of the NHS.

He also urged GPs to join an independent campaign against the polyclinics plan. The petition, drawn up by the think-tank "2020health" in consultation with the Tories, calls general practice the "foundation of the NHS" and says doctors object to "being forced into polyclinics against our will".

The petition also includes a demand for freedom to determine surgery opening hours.

"We want to work in partnership with GPs, not in conflict with them as this Government is doing," Mr Cameron said. "So I urge GPs to sign up to this petition and ensure that the next Conservative government has the backing of the profession to modernise general practice in a way that works for the staff and patients of the NHS."

Alan Johnson, the Health Secretary, last night accused the Opposition of backing a "free-for-all" that would end a recent agreement for more surgeries to open in the evenings and at weekends.

"This is an astonishing admission by the Conservatives. They are now supporting a free-for-all on opening hours which would see an end to the evening and weekend opening which has just been secured," he said.

"Far from diminishing primary care services we are enhancing them, but it seems that the Tories are more interested in ingratiating themselves with certain elements of the profession than they are in improving access for the public."

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2008/04/22/nclinics122.xml

Health Direct points out that every new major spin that labour dreams up tend to turn to ashes- just remember tough on crime, tough on the causes of crime.......

One in five GPs surgeries faces closure in polyclinic plans

One in five GP surgeries in England is set to close, threatening to end the era of a family doctor in every neighbourhood, an analysis of NHS plans reveals.

Labour government proposals to create a new generation of polyclinics will lead to the closure of 1,700 practices, the Tories claimed. In their place will be a series of "super-surgeries" housing up to 25 GPs and offering hospital-style outpatient appointments, minor surgery and pharmacies. While ministers hail this as a vision of 21st-century health care, opponents fear it is the death knell for traditional patient-doctor relationships.

David Cameron claims that the traditional GP surgery is at risk and only the Conservatives will save it.

The Tory leader delivered a speech to the King's Fund, an independent foundation working for improved health, on the future of primary care as the next stage of the party's "NH-Yes" campaign. It aims to reposition the Conservatives in the centre ground and seize the health agenda from Labour.

Health minister Lord Darzi, personally appointed by the Prime Minister to oversee the introduction of polyclinics as part of a major reorganisation of the NHS in England, has said 150 will be needed in London alone.

The Government insists they would create more choice for patients, offering GP, nursing and social care in one place. They would offer extended opening hours, from 8am to 8pm during the week, and weekend appointments.

But critics say those with chronic conditions, who need to visit their GPs more often than the typical patient, want the continuity of seeing the same family doctor.

Having fewer surgeries would also mean elderly patients who rely on public transport would have further to travel to see their GP. In London, patients would have to travel an average of 1.5 miles to reach their nearest polyclinic, according to the Government's own figures.

There are 8,261 GP practices in England, including 1,546 in the capital. Tory research, based on the Department of Health's estimates, shows that 1,701 surgeries in England face closure. Some 1,091 in London may go – nearly three-quarters of the total. In the rest of the country, 609 – almost one in 10 – could close in the next few years.

The research is based on the average number of GPs per practice in each primary care trust, and assumes each polyclinic would be staffed by 25 GPs.

According to a poll in Pulse magazine, eight out of 10 GPs are against the blanket introduction of polyclinics, warning it will dilute the personal relationship between doctor and patient.

The British Medical Association says it risks commercialising primary care as more services are contracted out. Just 8 per cent of GPs believe their local area needs a polyclinic, according to last month's poll. One in three GPs said they would refuse to work in a polyclinic.

Dr Laurence Buckman, chairman of the BMA's GP committee, said the Department of Health had shown little thought on how the local health service would be affected. He added: "Rather than being forced to create polyclinics, PCTs should be encouraged to invest in their local GP practices and support collaboration between practices.

"What works in London is unlikely to suit the needs of a rural community."

Andrew Lansley, the shadow Secretary of State for Health, added: "The Government is pushing ahead with forcing polyclinics in areas where they may not be needed. We are not against the idea in some places, but not at the expense of the local family doctor and patient care. Continuity of care for patients is at risk if their local doctor is closed.

"Patients will have further to travel and will be lucky to see the same doctor twice. The current relationship between GP and patient is one built on respect and trust, for the Government to wilfully destroy that is unforgivable."

Last year Mr Cameron launched a campaign to save the NHS, pledging a "bare-knuckle fight" with the Prime Minister over plans to close maternity and A&E wards in local hospitals. It ran into controversy when some of the 29 district hospitals the Tories said were under threat complained to the party.

But aides say the "NH-Yes" strategy will be centre stage of the next Tory general election campaign. They claim Mr Brown is planning a series of "NHS cuts" – language borrowed from Labour attacks on Conservative management of the service. They warn thousands of nursing jobs, hospital beds and acute wards will go under restructuring plans.

Lord Darzi produced an interim report on the NHS overhaul last November. A full report on the plans is expected in June. According to the minister's vision, patients will be able to see a doctor more quickly, possibly without an appointment, collect their prescriptions, get their eyes tested and see a physiotherapist all in the same building.

Ministers argue that the traditional family doctor of the 1940s, epitomised by the 1960s TV series Dr Finlay's Casebook, does not suit the modern needs of the NHS. Super-surgeries will include services currently only offered in hospitals such as minor surgery, diabetes screening and sexual health clinics, as well as access to traditional GPs and practice nurses.

But critics fear polyclinics will attract large private companies who can outbid local GPs. Union leaders accuse the government of privatisation by stealth and are planning to fight the moves.

GPs fear for their relationship with patients, claiming polyclinics will employ more salaried doctors who are unlikely to stay and work in one place for as long as partners in a local practice, many of whom spend a lifetime attached to one surgery. And while younger, "healthier" people are most concerned about easier access to doctors, patients with long-term conditions such as diabetes, asthma and depression, place greater value on seeing a doctor they know.

Dr Anthony Halperin, chairman of the Patients Association, warned last week: "We are concerned the personal contact with a GP will be lost within a polyclinic because another layer of treatment is being introduced."

Chronically ill patients and the elderly, who are the biggest users of GP services, would prefer to wait a day and see a doctor who knows their history, argue patient groups. And older and disabled people could be unwittingly excluded from the new clinics because they are too far away and difficult to get to.

The British Medical Association has written to Lord Darzi warning against a blanket introduction of polyclinics across the country. But ministers have reportedly told primary care trusts that they have no choice in backing a polyclinic in their area, even if there is already a large health centre nearby.

Another concern is that the £12bn NHS IT system which has already been plagued by delays and technical glitches is not designed to meet the needs of polyclinics.

The NHS Confederation, which represents local health service managers, said in a report published last week that the IT system would make it difficult to share patient information between primary care, social services and the independent sector. Sharing information across a range of departments is essential for polyclinics to work.

However, the NHS Confederation director of policy Nigel Edwards said there had been a "knee-jerk" reaction to the proposals. He said: "While it may sound like the polyclinic system will not resemble the service currently provided by family doctors, in reality it should build on what is best in general practice."

http://www.independent.co.uk/life-style/health-and-wellbeing/health-news/struck-off-one-in-five-surgeries-faces-closure-812177.html