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July 2008
Recent proposals have been put forward by the Government for the creation of 271 ‘polyclinics’ across England. With the aim of modernising the health service, the proposed ‘one stop shops’ for healthcare would supposedly provide better quality and patient access. There would be approximately 121 polyclinics outside London and 150 within the city, each with about 25 GPs in practice.
These new super-practices would be set up to improve access for those in need of medical attention. However, estimations suggest that many residents outside London will have to travel 3 or 4 miles to reach one of these centres, which could cause problems for the elderly or very ill. Designed to improve the quality of care patients receive, opinions are currently mixed as to how successful the polyclinic model will be, with only four in ten consultants saying the polyclinics will increase patient care. The plan also intends to make it easier to book appointments, due to an increase in the number of GPs available. As good as this may sound, most of the public would prefer to remain close to one GP alone. In the recent survey of 24 Primary Care Trusts, only one in ten patients favour the polyclinic model over the current system.
These plans are giving deep concern to Mole Valley doctors and their patients. To quote one GP they would be like “black holes – sucking resources and patients who could travel into the centre which would mean our many village and town GP surgeries will starve and die.” Having already lost so many village post offices and shops, the loss of their GP surgeries will be severely damaging to rural residents. In spite of the obvious threats, the Secretary of State for Health claims not a ‘single’ GP practice will close. However, there are concerns that this would not be the case and that whilst the polyclinic model makes sense in large towns and cities, in rural communities local residents’ primary concern is for an easily accessible GP so they do not need to travel far for a minor complaint. Similarly, local healthcare providers, such as the Dorking or Leatherhead Hospitals, already offer many of the services which the polyclinics are intending to make available. The Mole Valley GPs I have spoken to would prefer any extra funds to enhance the services we already have in Mole Valley.
With regards to the future of polyclinics, the NHS Operating Framework has reportedly instructed each Primary Care Trust to create a polyclinic within the year, so we can expect the first to be in place in the not too distant future.
The Government’s new Pharmacy White Paper is intending to give a much greater role to pharmacists themselves in providing extra services such as risk assessment, screening, health and lifestyle advice and medicine use reviews. This seems to be a popular idea as people would no longer need to visit the hospital or doctor for these services.
However, the document also outlines the removal of many GP surgeries’ dispensaries, in an attempt to allow only professional pharmacists to dispense prescriptions. MPs in rural areas, such as Sir Paul Beresford MP for Mole Valley, have voiced concern over the inconvenience this may cause to people without a pharmacy nearby. Local, remote surgeries often dispense their own medication to save their patients the journey of going to pharmacy. For example, the village of Shere currently has a large dispensary in its GP surgery which saves residents from having to travel to collect their prescription from the nearest town with a pharmacy, such as Dorking or Guildford.
The responsibility of dispensing is not one taken lightly by doctors. In 2006, the 1170 dispensing practices in England administered over 7% of the total prescriptions given. Although the move to a more professional and equal pharmaceutical service nationwide is a good way to maintain high standards, dispensing doctors in the countryside provide a vital service. Furthermore, if surgeries were disallowed from dispensing, their income would decrease, which would leave them with less money to reinvest into the practice which would ultimately lead to a worse service for patients and the potential closure of some of our smaller village GP outposts.
The Government has agreed to produce a comprehensive and genuine consultation before any future plans are made. This consultation will hopefully consider the needs of rural areas. On 22 July, Sir Paul delivered an adjournment debate in the House of Commons on polyclinics and the Pharmacy White Paper.
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