I Told You I Was Ill

I really don't know about this one: Ignore GPs. Polyclinics are the future. My first thought was that DA was being a 'friendly journalist'/'useful idiot' for the government position, but I think he has some good arguments. Shorter DA: GPs are out of date; we need something new. There are some poor arguments as well as the convincing ones.

When I saw this claim, I thought long and hard about it. And decided that this "holistic" approach [ie the current GP], is, in fact, code for "inexpert". What I increasingly want from a practice is accurate and fast diagnosis and screening, combined with the best possible advice about my condition. At the moment I tend to use my GP's practice as a way of getting referral to specialists and accessing prescriptions that I have already decided that I need.

Against this, I think calling anyone with six years university education behind her "inexpert" is a shade disingenuous. I think we've always wanted fast and accurate diagnosis (with the latter having priority). If screening requires special equipment such as x-ray machines, you're not going to get those outside of a hospital anyway. And if Dave knows what he needs before a doctor does, bully for him, but he should consider it possible that he may not always know best.

One GP further complained of how polyclinics were part of "this 24-hour, consumerist environment [which] has raised demands for a 'dial-a-pizza' approach to healthcare - instant gratification with least discomfort - with the profit-based business model that motivates supermarkets". It is hard to imagine a more contemptuous attitude towards patient demand. When did illness stop being 24 hour? And since when was minimising discomfort regarded as being somehow un-NHS?

Here he finally began to win me over. I think those are fair points. So I'm on the fence here. If anything tipped the balance, it was my dislike of anonymous comments. The first comment is from "Dr GP, London, London [sic]". And I'm the highest regarded Proust scholar in the US but I'm not going to give my name.

Edited to add I should have included a link to the Times letters in reply. I read this after Captain Cabernet's comment, and the third letter clarifies my position. (It's from a GP - I assume - in Cardiff where I live, but I don't know him.)

Sir, I don’t think most UK GPs would be too upset if we ended up with Scandinavian-style polyclinics, but the recent past would suggest that we are more likely to end up with a cross between the out-of-hours care fiasco and the patchy level of NHS dental provision. Private companies will only want to operate in "profitable" areas. The government drive for cost savings would mean the polyclinics being run by private companies employing overseas-trained doctors on short-term contracts. When complex medical problems are encountered then the quickest, cheapest way to deal with them will be to pass the buck to the hospital sector. The cost savings would be rapidly swallowed by increased admission costs to A&E.

To be clear, I don't object to the polyclinic idea or to NHS reform. I do distrust this government (and the Tories too) when it comes to running things and I side with Capt Cab on GPs/clinics "paying foreign locums to do the actual work for them".