Polyclinics : Part of the plan to dismantle our NHS

Government plans for the NHS?

First you create chaos, busily privatising as you go. And five years or seven years down the road, you say, ‘What a shame; we’ve put all this extra money into the NHS and it just isn’t working’ – and then you move to an American-style private insurance model. There is little question that this is the direction of travel, if Brown and his mates get their way.

The forced introduction of polyclinics is a good example of this. There has been excellent media coverage of the issue over the last couple of weeks – thanks largely to the fine work done by the BMA.

Polyclinics are absolute madness. Every informed opinion – including the BMA, Unite and the Kings Fund – is in agreement that polyclinics are not in the interests of patients.

The Government, responsive as ever to public opinion, came up with a solution. Polyclinics have had such a bad press that they’ve changed the name. Polyclinics are now known as ‘GP led health centres’! Problem solved.

In London, the intention is to close down the existing network of GP surgeries and create around 150 polyclinics. Across the rest of England, every Primary Care Trust has been instructed to create at least one polyclinic – whatever the cost to local services.

Most of us think of the NHS in terms of heart attacks, cancer surgery, and road traffic accidents. TV programmes like Casualty and Holby City reinforce this view. In fact., most NHS care is a lot less glamorous. At least 80% of NHS appointments are in primary care – GP services, of course, and also health visiting, district nursing, physiotherapy and so on. Most of us use these services occasionally – but the main users of primary care are older people, people with disabilities, and small children.

Polyclinics will be ‘health factories’ – bringing together around 25 GPs, a range of other health workers, and diagnostic facilities like X-rays, MRI scans and blood and tissue tests. Many of the outpatient appointments and minor procedures now carried out in hospitals will move to polyclinics.

Superficially, this sounds great. But the likeliest model is that a majority of existing GP practices will close. In practice, therefore, polyclinics reduce access to primary care. If you’re 85 with severe arthritis, getting on a bus and travelling a few miles up the road to see your GP is not practical. Likewise for many disabled people, and many parents of small children. In rural areas, the concept of replacing existing GPs with polyclinics is a conspicuous nonsense – but the Government is still forcing this through. For most users of primary care, getting to see your GP or practice nurse or taking your kid to the baby clinic will be much, much harder.

Any concept of a personal relationship with a GP who knows you and knows your family is of course destroyed. This is one of the most valued aspects of our current family doctor service – and it’s set to be wiped out. You don’t get person-centred care in a polyclinic health factory.

It’s worse even than that. Polyclinics are a glorious opportunity to drive through yet more privatisation of the NHS. Primary Care Trusts have been told by the Department of Health to use an ‘Alternative Provider Medical Services’ route – meaning, in practice, using the companies like United Health and Care UK that are tearing apart our NHS.

And the final straw is that shifting services out of hospitals and into polyclinics – in an unplanned way, and at a time when hospitals are at risk financially through PFI, ISTCs, payment by results and the like – will force through massive cuts and closures in NHS hospitals. Again, patients suffer.

We’ve got a weak and vulnerable Government. Alan Johnson is very much on the defensive where polyclinics are concerned. It’s absolutely time to step up the pressure around this issue. The BMA site Support Your Surgery has some good practical ideas. Trade unionists should raise this as a campaigning issue. Every Keep Our NHS Public campaign and community campaign needs to take this up. Let’s write to PCTs, write to local papers and so on.

Another idea.

Respect/Left List Councillor Michael Lavalette has submitted the following motion to Preston City Council:

Preston City Council notes:
1. Government plans to introduce polyclinics across the country.
2. Central Lancashire PCT plans for a polyclinic in Preston.
Additionally Council notes:

1. Polyclinics can divert public funds to private health care providers, as such they are part of the continuing privatisation of the NHS.
2. The number of private, for profit, companies winning contracts for GP practices is growing
3 There has been little consultation over this initiative.

Preston City Council further notes:
1. The valuable role played by GP’s in the healthcare system and their central role within the NHS system.
2. GP’s provide a key role in the delivery of local, community health care.
3. Polyclinics may open for longer hours but will be further away from patient homes (impacting negatively particularly on elderly patients) and will provide an impersonal service.
4. Polyclinics are likely to have a destabilising impact on local hospital and GP services.

Council therefore:

1. Reasserts our commitment to a public health service: free at the point of use and provided from within the public sector.
2. Instructs the chief executive to write to the Central Lancashire PCT informing them of our opposition to the ‘rush’ towards polyclinic health centres and our concern at its impact on local NHS and GP services.

We may not all have councillors with Michael Lavalette’s record of principled activism and campaigning – but let’s hold the politicians we have got to account. This is an opportunity to advise MPS and councillors that if they nod through the destruction of our health service, their seats are on the line. If they’re not willing to defend the NHS, maybe it’s time to elect some more Michael Lavalettes.

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