To the Editor Shrewsbury Chronicle,

It may be that your readers do not fully understand the risks posed by Shrewsbury’s Darzi clinic (also described as a Polyclinic, a drop-in surgery or a GP-led Health Centre).

Shropshire’s Health Overview and Scrutiny Panel agreed unanimously: Conservative and Labour, Liberal Democrat and Independent all agreed that this was not the best way to help the people of Shropshire. The Health Overview and Scrutiny Panel had a responsibility to consider both the quality and the value for money provided in healthcare to the people of Shropshire. The Polyclinic model was devised by Lord Darzi a surgeon who was given a peerage by the Labour Government and asked to look at the Health Service. He looked at services in London and came up with a proposal that every Primary Care Trust (PCT) including our own in Shropshire has been obliged to implement. The PCT has been very cagey about costs but it is rumoured that this clinic is costing £10million. It is likely that it costs about three times to see a patient in this clinic as in normal General Practice. At this time twenty Practices around Shropshire, including some in Shrewsbury were in a queue waiting for cash to improve their practices. The committee felt that the Polyclinic or Darzi clinic was not the best model for Shropshire and wrote to the Secretary of State for Health to say so. The reply suggested that the Local PCT had some choice, but over successive meetings it was made clear to us that there was no freedom of choice for the PCT and the clinic went ahead.

Apart from the missed opportunities to spend scarce NHS resources more wisely the use of private providers in the NHS poses other risks to the patient.

The inquest into the death of David Gray has heard this week of concerns around the private company that was contracted to provide out of hours care in Cambridgeshire.[i] The company admitted to being under financial pressure and having reduced medical cover. They employed a German doctor who was not familiar with British General Practice or with British prescribing. He gave an overdose of a painkilling drug and the patient died. There were other concerns about this particular doctor, and other concerns about the company that employed him. That company has lost two of its contracts with the NHS but despite local concerns they continue to hold the contract for services in Worcestershire[ii]. In October The Care Quality Commission expressed concerns about this company, and about the ability of PCTs to monitor the quality of service being provided.[iii]

Less dramatically, but potentially of even greater significance is the potential for confusion caused by the current fragmentation of the NHS. For many years patients would access almost all their healthcare via their own GP. The GP would refer the patient to any services that they need, and the GP would keep a record of all treatment a patient received and all the drugs they were taking. The Government’s deliberate and acknowledged aim to offer a “diversity of providers” now means that the patient can access health care through any one of five routes. I am aware of a patient who was admitted to Intensive Care seriously ill, having previously consulted three different organisations that did not communicate with each other. When admitted to hospital the patient reported that he had been treated for swine ‘flu by his GP. In fact none of the organisations that he had consulted was his GP and none of them had communicated with the GP.

The Government’s agenda to break up and privatise the NHS may work fine for the typical MP who is a young or middle aged man with no previous illness; it brings serious risks to the older patient who may have a number of important previous illnesses, and may be taking several drugs already.

[i] http://news.bbc.co.uk/1/hi/health/8455971.stm

[ii] I notice that Take Care now’s website is off the air, but I am told by Worcester Primary Care Trust that they are still providing their contract.

[iii] http://www.cqc.org.uk/newsandevents/pressreleases.cfm?cit_id=35381&FAArea1=customWidgets.content_view_1&usecache=false

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