Sometimes, two news stories seem made for each other. And so it was this week. First, we had the Save Bridlington Hospital Campaign Action Group claiming that cuts have hit their local hospital so hard that a nurse was left to run a 30-bed ward on her own, seriously compromising her coffee break. And that was followed by a report about a hospital in Lincolnshire, which has taken to using life-sized cardboard cut-out nurses to give a recorded message reminding visitors to wash their hands.

See? One story solves the other. Simply send to under-staffed Bridlington Hospital a lorry-load of cardboard nurses programmed to say things along the lines of: “Have you opened your bowels today?” and “I know your stump's not healed yet but we need the bed”. I'm not sure exactly how far this cost-cutting concept has progressed but, if I was going in for a bypass, and I noticed the anaesthetist and his heart-lung machine wobbling like a Crossroads stage set, personally I'd decide I suddenly felt better.

That said, innovations of this sort have potential in primary care. For example, given how often I power-nap during consultations, I've long suspected that I could be replaced by a cardboard cut-out, saying, at regular intervals, “Really?”, “It's probably a virus” and “Let's run some tests and see you in a week”.

In fact, this vision of future GP consultations may not be that far from the truth, given the Government's obsession with polyclinics - because the doctors running these Brave New Surgeries may well be one-dimensional automatons.

In case you've not been following the polyclinics plot, let me explain. Polyclinics are new, centralised, all-singing, all-dancing, all-hours health centres, and they're the brainchild of surgeon and government adviser Lord Darzi. He has suggested that the development of these super-clinics should be based on evidence, need and consultation, which is fine. But this has been interpreted as, “every primary care trust must build one”, which is not.

We GPs have a number of objections. One is that we should no more tolerate a surgeon advising on the future of general practice than Lord Darzi would tolerate a GP taking out his appendix, though sometimes I'm tempted to try. Another is that polyclinic docs may end up working for primary care providers who are interested in making money rather than making you better. So what you'll gain in access and shiny services, you'll lose in terms of continuity and advocacy. This means that instead of your trusted GP you may get a shift worker with all the empathy skills you'd expect from a piece of cardboard.

That may not bother the money-rich, time-poor, worried well. But it's a problem for those who really need a good family doc, such as the elderly and those with chronic disease. They can't easily travel to the nearest Darzi centre, they value a doctor they know and who knows them, and they want a GP who keeps an eye on the whole picture rather than one who deconstructs their multi- pathology to its innumerable individual components just because polyclinics run lots of, well, clinics.

Frankly, it's a problem for us GPs, too. Polyclinics will be polyfilled with the low-workload masses they've creamed off the local practices. That leaves us with the really tough stuff. I'm not afraid of hard work, but I do rely on the odd sore throat and quick pill check to counterbalance the complex cases of the typical morning surgery. This helps me run to time and prevents my brain from exploding. Not that I should worry. After all, the destabilising effect of polyclinics may mean that many traditional GPs - those who provide a personalised service and who score highly on satisfaction surveys - will have to shut up shop.

In the meantime, I'll just have to concentrate on some of my own cost-cutting. So where's that cardboard? I've got a practice manager, two nurses and an effigy of Lord Darzi to cut out.

Dr Copperfield is a GP in Essex. He also writes for Pulse magazine and pulsetoday.co.uk

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