ALTON MP Michael Mates was in town last week to pick up a petition signed by more than 1,000 local patients concerned about developments in primary health care. They had signed a 60th Birthday Card to the NHS, to send a message to the Government that they value and support their existing GP practices and would be totally opposed to the development of large, privately run polyclinics. According to the British Medical Association (BMA) the signatures were added to more than 1.25 million others, gathered during the course of just two weeks from surgeries nationwide. "We are delighted that patients have joined doctors and practice staff to highlight concerns about proposed changes to GP provision," said Wilson Practice GP, Dr Andy Fellows. "The NHS requires every PCT (Primary Care Trust) in the country to develop a GP-led health centre (also known as a polyclinic) in its area, regardless of existing GP cover. This blanket approach takes no account of current provision – and is a potential threat to hardworking, established practices." Mr Mates was equally concerned: "Across England it is estimated that 1,801 GP practices might have to close if the Government proceeds with its plan to group GPs into polyclinics made up of 25 GPs each. "This proposal, which was originally proposed for the very particular circumstances of London, could change fundamentally the relationship between doctors and patients which from the earliest days of the NHS has been based on the principle of every patient having a named GP that they can see." Having attended the BMA meeting in London last week as the GP representative for Hampshire, Alton based Dr Terry Cubitt (Cubitt Practice) confirmed the concerns expressed that the setting up of large commercial clinics in the Camden area of London had destabilised GP practices in the area. He said that local GPs had not been in a position to bid against an American company that had been offered financial inducement and been able to respond to the bidding process at speed. The American company had promised better value for money but already it was reneging on its commitment by providing fewer doctors and asking for more money to provide what was viewed as "a less effective service". Dr Cubitt pointed out that, with less well trained GPs contracted on a short-term basis, no supporting case notes and no in-house training obligation, patients using the polyclinics could not expect to receive traditional quality and continuity of care. Having already been kicked in the teeth by a new contract that, having encouraged GPs to meet Government targets, ended up penalising them for over-performing, there is a lot of anger over this latest proposal that doctors fear could further destabilise the system, he said. While the new facilities will at first be funded by central government resources, the concern is that PCTs will have to pick up the cost and that this will impact on regular GP practices. "Each year the BMA endorses support of the NHS. We don't want to return to a private system that penalises the disadvantaged. We need to continue providing free care for everybody at the point of service," said Dr Cubitt. Dr Fellows believes that while the concept of drawing medical services, including diagnostics and some treatments, together in a single building is sound the facility has to be appropriate in size to the community it serves. "Alton Health Centre was designed to work in that way back in the 1970s. The important difference is that the size and scope of the Centre was appropriate to the community it served, and there were other centres developed to serve neighbouring populations. "There is a national strategy to encourage PCTs to commission more services closer to patients, so fewer people have to visit hospital outpatient departments to see a consultant, or for diagnostic work, day surgery or other treatments. The development of centrally-located polyclinics appears to run counter to this strategy," he said. The future of Alton Health Centre has been under the microscope for several years after the splitting of the Wilson and Cubitt practices to give each more room to function.
