The Poly Clinic Debate
With the publishing of the King’s Fund major analysis on polyclinics the debate on their possible future is again thrust into the forefront. The BMA appears to be sceptical about their introduction, no doubt due to the fact the GPs fear that some of their powers could be erroded.
Dr. David Colin Thome who is leading this ininitiative along with extending GP practice hours was at pains to point out when interviewed on this morning’s Radio 4’s ‘To-day’ that extending practice hours should not be confused with the introduction of Poly Clinics - there appears to be a joining of the two in people’s minds whereas they are separate issues.
Poly Clinics or ’super surgeries’ involve the joining to-gether of practices under one roof to provide not just more GPs but extra facilities, e.g. x-rays, minor operating theatre, occupational therapists, physiotherapy etc. Interestingly this works effectively in other countries, e.g. Germany, however they organise their medical workforce differently…..and this rather than care delivery we fear is the crux of the problem. To run Poly Clinics successfully you need community based specialists as in Europe, in the UK specialists are hospital based, therefore there would need to be a real change in medical workforce mindsets for the clinics to work successfully.
Perhaps we need to ask the question why shouldn’t there be specialists based in the community? They would only refer to the hospital based specialist if admission was required. Perhaps we need more specialists……
In cornwall we have managed to hang on to some of our community hospitals by the skin of our teeth, albeit they are mostly used to rehabilitale older people. Were not these in the past the forerunners of Poly Clinics? Sadly there was the huge rush towards centralising the majority of hospital services at Treliske, which saw the loss of specialist services in places like Penzance at West Cornwall Hospital.
Isn’t it really time that there was a reality check for local populations. We’re told that the survey by the local PCT found there was no requirement for extended hours in GP surgeries in Cornwall. This is truly unbelievable if the working population of Cornwall were the ones included in the survey. Doesn’t it occur to anyone that extended surgery hours may actually reduce hospital admissions and out of hours calls.
Medical care is not just required during office hours, people need to access services when they aren’t working, on their way home or at a week-end. One of my young friends is a medical student in his third year, when asked where he thought he would work after quallifiying he said he could see himself working in Tesco. He didn’t mean stacking shelves or behind a till, he meant in a surgery alonside the supermarket. Come on Doctors, see the writing on the wall, if you don’t grab the ball and run with it then someone else will, and I’ll be calling in at the supermarket on my way home to visit the Doctor alongside collecting something for dinner.