I think my local GP practice in Highgate is fantastic. In one form or another I have been going there since I was a child when it used to be at the bottom of Jackson’s Lane – even before it moved to North Hill. I can walk to it. I am familiar with it. And instinctively I don’t want to have to go anywhere else if I am ill! And I would guess that most people feel the same about their local GP practice; or if they don’t and have problems with their local GP practice (or don’t have one) – what they want is a high quality local practice.
But that doesn’t seem to be our government’s vision for health services. The London Plan proposes super-duper special hospitals for stroke, heart attacks and major traumas to save lives. Then there are a series of rationalisations around district hospitals, A&Es and what health services are offered where. And the bit that I wanted particularly to bring to your attention and which will be part of a consultation exercise by the Haringey Primary Care Trust is the plan at the local level. The Government envisages five or six ‘polyclinics’ for Haringey.
The first polyclinic is likely to be the long, long awaited, new health facility to be developed on the site of the old Hornsey Central Hospital.
The positive version of this is that these new polyclinics would have fantastic facilities for diagnostics, chiropody, midwives, sexual health or whatever is needed locally plus GP practices to serve up to 50,000 people. In other words – you go to one place and get a wide range of services delivered then and there, without having to shuffle between GP and hospital with all the delays and travel that involves. Fast, expert service that means people don’t have to be committed to hospital – that all sounds to the good doesn’t it?
But there could be another side to the polyclinic story. To be viable each polyclinic will need to have a large GP practice on site, so that could mean GP practices being centralised. Will larger practices be a good thing – with all the problems of them possibly having less of the human touch, not seeing the same person twice in a row etc.? And depending on which practices end up moving to the polyclinics, and where the polyclinics are located, will lots of people end up finding that their ‘local’ GP practice now isn’t so local after all?
The result of introducing polyclinics could be centralised, distant and out-of-touch services – as we have seen in so many other areas of public service, such as the police (though, to their credit, many in the police now want to return to a greater number of truly local points of presence).
That is why we, the users of our health services, need a proper say on polyclinics – not a consultation that takes no notice of our views or is so vague in what it asks that we don’t really get to judge the possible outcomes.
One of the key questions to me is: what percentage of people going to a GP currently can be treated by the GP and what percentage need referring on? The higher the proportion of people who need referring on to another service, the more attractive polyclinics are, where those other services will often be right there on the same site. Now – you would have thought this sort of figure would be a key part of the polyclinic decision-making. But when I asked the local health trust couldn’t tell me – so I shall put down a Parliamentary Question on this.
Polyclinics may be a brilliant way forward for our local health facilities – but I want us all to have a proper say in any proposed re-organisation of our facilities and both our GP practises (who operate as small businesses now and who will make their own decisions on any changes to their set-ups) and the local Health Trust need to involve us – the users of the service.
Interested in reading more about polyclinics? Read the postings about polyclinics on my blog.
An earlier version of this article first appeared in the Highgate and Muswell Hill Flier.