BMA opposes plan to replace GP surgeries with Polyclincs

Discussion in 'Current Affairs, News and Analysis' started by Scabster_Mooch, Feb 16, 2008.

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    Personally I think polyclinics are a good idea. IMO, the British medical profession is a bit of a joke. Working office hours and whinging about having to open on weekends etc. Now they want to protect their own way of doing things because essentially that is the way it has always been done.

    I say open the polyclinics, make them open 7 days a week and force GPs, whose education have been heavily subsidized by the state, work in these clinics as part of their professional development.

    Patients win.

    The only concern I have is according to the BMA,

    This should be run by the bleeding state not by some money grubbing private coy who will make an unrealistic tender, then extort more money by threatening to up tools and therefore leave a community without coverage.
  2. Absolutely barking idea. The only ones to benefit from these centralised 'one-stop shop' affairs are the Govt as economies of scale are realised. For the patient it is a nightmare.

    Longer travelling times alongside limited public transport provision, with those travelling by car facing limited parking and being charged for the privilege. In addition, the wealth of other services that will sit alongside these polyclinics - probation, welfare, neighbourhood police, job advisors - will turn them into a magnet for the mentally ill or those that just require somewhere warm to pass a few hours.

    I believe Colchester tried something like this, but it just didn't get off the ground. One, because of local opposition. Two, because many existing GP premises are combined with their living accommodation, and are intended to form the GP's pension pot as he sells the practice on retiremement. If they are no longer able to be used as GP practices they lose considerable value, something that GPs would have to be compensated for if they were to be persuaded to leave. Replicate this problem across the nation and it is clear that this initiative just won't get off the starting blocks.

    PS The point about not working out-of-hours is invalid. GPs used to provide this service until the Govt decided to fiddle with provision of GP services, which effectively killed it off. If they want GPs to resume out of hours provision they will need to pay them to do so.
  3. Privatising OOHs were a big mistake and currently costs far more than it ever used to under the old GP co operatives, because the DoH was following a political agenda, just as they are with polyclinics, they are paying top whack. Look at all the wasted money paying for unused capacity in Independant Sector Treatment Centres.

    By the way who do you think does the OOH shifts - the same GPs who do the day surgeries, and a few foreign GPs who fly over for the weekend - because it is such a money spinner. Dont blame the GP, blame the politician for constantly meddling.

    Did you know SERCO were bidding to enter into health provision? This is about privatising the NHS nothing else and should be resisited at all costs unless you want your health in the hands of the cheapest bidder and never mind the quality or continuity of service.

    As fit young men and women you might think it doesnt matter, but I am sure you all have an elderly relative who benefits from continued care on their doorstep and one day you too will be in civvy street needing help from what despite everytinhg is a health system the envy of the world.

  4. BiscuitsAB

    BiscuitsAB LE Moderator

    The Sale of GP practice buildings to PLC's and the Larger American and Canadian companies is fundamentally wrong. And thats speaking as a firm believer in Capitalism.

    The reason why it is wrong is this " The Government still pays the Rent on practice loans, either on a cost rent or notional rent basis". This means that Anyone can go to the bank and borrow the money to buy the practice building because the bank knows that the goverment will meet most if not all of the monthly interest payment. EDITED TO ADD. Notional rent is reviewed by the district valuer every three years. So if the borroiwing remains stable and the rent goes up then as well as building up capital in the asset the owner is in receipt of income. Of course rents can come down but that doesn't happen very often at all in my experience.

    Effectively the tax payer is all ready subsidising the purchase of practice buildings. Why should a corporate entity benefit from this direct funding?
    I've got no beef with my local GP owning their building as when they retire they sell their share to the incoming partner.

    Portfolios of health care buildings are already regularly appearing on the open market and sell very quickly because the Yield is normally very favorable. And even single practices are available to purchase as th ecase with a friend of mine who has just bought one in Edinburgh.
  5. This is just another destined to fail cost-cutting scheme from the goverment just like PFIs. Although these schemes save money short term, they invariably end up costing millions more in the long term and drastically reduce the quality of health care provided. Well done Gordon Brown!!
  6. They all ready are in Cornwall and doing there usual standard of poor service and must try to do better hand wring apoligese when it all comes to the public gaze. :x

    Drrant points out the reality of what is the way forward for health care under liabour...
  7. Another bit of Socialist dogma "bigger is better" ie more control from the centre.
  8. Saying GPs only work office hours just shows your ignorance.
    GP on call from 0700 and often visits patients on way to work.
    Surgery normally 8.30 to 11.30 which don't finish until 1 pm due to people screaming emergency for colds, coughs etc. Hey, the service is free, why not whinge about coming in?
    Don't know any GP who has a lunch break, usually a sandwich on the run as the home visits (regardless of what the perception is, they usually do 4 or 5 visits daily). Afternoon surgery from 3.00 to 5.30 which goes on to 7.00 for same reason as above. Paperwork (all those insurance reports, incapacity benefit reports etc don't complete themselves). Wives of GPs in my practice often complain they are on the go to 10 or 11 at night completing the paperwork.
    In addition, the governments obsession with targets usually means the only time they have to do them is at the weekend.
    This is every day throughout the year. Bit like the public's perception of the Army, always whinging about being in a combat zone but only go for 4 months every couple of years. Why aren't they all out there, all the time etc. etc. You know very well the military do a lot more than that.
    And don't believe the cr@p about the huge pay the GPs all now get. GPs have to pay for all their own staff, utilities, supplies etc. All that "extra" money would be great but increase for hitting targets is £145,000 a year. Divide that by a group of 10 doctors and its not a fantastic amount. Single handed GP has to pay another doctor to come in if he wants holidays, training courses etc so that money gets eaten up very quickly.
    Superclinics? Goodbye to GP/patient relationship. Bit like Tesco versus the family grocer. Sad day when it goes.
  9. Read some of the GP blogs. What's happening to the NHS is a horror story.

    Surgeries where you have to see a nurse first who decides whether you're sick enough to see a doctor (which will require a separate appointment). Tough sh1t if the teenage nurse misdiagnoses your brain tumour and sends you home with a packet of asprin.

    Read Dr Rant's recent rant about a 'nurse practitioner' who couldn't tell the difference between fluconazole and flucloxacillin. (Hint: One is an antibiotic used to treat infections in new mothers. The other is an anti fungal drug that would have been excreted in the patient's breast milk and poisoned her baby).

    Suicidal patients who can't even see a nurse, never mind a psychiatrist. "The nurse is off sick, you'll be seeing our gender reassignment co-ordinator. Call him Tracy and don't stare at his receding hairline and hairy legs".

    The class war brigade in the government hate GPs. If they push them too far, the GPs will opt out of the NHS as dentists and opticians have done. GPs will then only be available to those who can pay with the rest of us queueing up at A&E as happens in America.
  10. The afore mentioned Dr Rant is in fact a group of several people - as much journos as NHS doctors apparently - probably Daily Mail hacks at that.

    Here is a quote

    "All members of the Dr Rant team are doctors working in the NHS and/or medical journalists/writers."
  11. You are right. I do not have insider knowledge. My opinion is shaped by my experience and my experience is getting hold of a GP outside office hours is difficult. Getting hold of one on weekends is like finding the holy grail.

    Neither of these is acceptable because it makes no rational sense for GPs to open at 0900 and close at 1730.

    I think this country needs to get a grip on these things. I like the idea of 'polyclinics' because in my experience it means that you can have sensible opening hours IE opening till late at night and on weekends. This is possible because there are greater numbners of doctors working in the polyclinic and some kind of shift arrangement can be made. As well, I never did see the point of having pharmacies when doctor's surgeries should be capable of doing the dispensing. In a polyclininc these functions should be consolidated.

    Of course, the govt, in its wisdom has decided to involve private bidders to run these things. I do not agree with that though I agree with the principle of polyclinics.

    I do not believe in that wooly relatioinship nonsense. That will affect only a minority of people as most ppl see the GP infrequently. The needs of the masses should trump that of the few esp when the detriment on those few is intangible.
  12. We have polyclinics in Spain. In my rather limited experience they work well. GPs seem to my layman's eye like a rather overpaid bloke who looks up your symptoms on wikipedia then refers you to the appropriate specialist. I get the feeling their complaints here are those of a middleman about to be cut out.
  13. Daily Mail hacks? Are you on another planet? The Dr Rant team would be most amused.

    The NHS is being sold down the river (PFI, ISTC, polyclinics & whatever else NuLab have in mind) and the taxpayer/patient is being shafted hard. Management Con.sultants and all their kind are making a mint, whilst acute care goes into meltdown. You only have to look at the ludicrous use of ISTCs (paid over the odds, for a lower volume of less complex work) to see the idiocy of current reform.

    I'm not going to defend the system where it falls down, but there was some truth in the old adage that "when the NHS is good, it's very, very good." That is fading fast - you only have to look at the career plans of the despised Patsy Hewitt to see what's coming.