You don’t know me. I don’t know you. Now, what seems to be the problem?

The government’s plans for large new health centres called polyclinics have Tracy Posner worried. The mother of two and company director from London used to attend a similar sort of centre and knows to her cost what can happen.

When Posner started to develop a series of debilitating symptoms, she saw a different doctor every time at the large clinic – and none was sure what the problem was. She was placed on antidepressants and told that she was suffering from stress.

When her condition continued to worsen and each new doctor dismissed her concerns, she took matters into her own hands and had an MRI scan privately. It revealed that she had a large brain tumour.

Posner blames lack of continuity of care for the errors: she is now registered with a smaller GP practice where she sees the same family doctor at every consultation and can correspond with the GP by e-mail. Not surprisingly, she is wary of plans for polyclinics designed to open seven days a week, staffed by doctors working shifts.

“I feel very strongly that, had I been able to go to the same GP, my brain tumour would have been diagnosed much earlier,” said Posner, 47.

“Because I saw a different GP every time and went to the large clinic, they didn’t know me. If they had known my history and family background they would have taken me seriously.”

On the other hand, Colin MacDonald, a father of two from South Tyneside, believes a polyclinic could make his life a lot easier. Like many working couples, MacDonald and his wife Donna struggle to book a GP appointment for themselves or their children at a convenient time. They would welcome a health centre that is open until 8pm and at the weekends.

“If one of the children is ill, one of us would most likely have to take time off work,” MacDonald said. “We have even been forced to call out an ambulance once or twice when one of the children has fallen ill in the evenings. Sometimes I have used NHS Direct [the telephone advice service] but if it is anything serious you are advised to go to the accident and emergency department. I would much rather visit a local polyclinic than a busy hospital.”

The opposing views of Posner and MacDonald reflect the bitter divisions surfacing over polyclinics. The government says GP services need to be transformed to become more convenient for patients. The British Medical Association (BMA), the doctors’ union, insists that most patients are content with their family doctors. Patients are caught in the middle, some for the plans, others against.

The conflict intensified last week when the BMA delivered a petition of 1.2m patient signatures to Downing Street, collected in just three weeks and opposing what it claims are secret government plans to shut thousands of GP surgeries.

Health ministers insist the polyclinics will not be an alternative to existing surgeries. But the Conservatives calculate that more than 1,700 practices will need to be closed to make way for the super-surgeries.

What is clear is that the government is proposing initially to create 150 polyclinics – and there have been suggestions that there will eventually be at least one in every primary care trust (PCT) in the country. PCTs are the regional bodies responsible for GP services.

The polyclinics will be staffed by up to 25 doctors and will be open 8am to 8pm seven days a week. Some will house dental surgeries, offer diagnostic tests, pharmacies, physiotherapy and even minor surgery, but others may be more like the “walk-in centres”, treating patients who find it difficult to get an appointment with their GP.

The first ones will be opened in London, where 31 PCTs last week agreed to implement the plans, but will later spread nationwide. Ministers say the demand for polyclinics has arisen in response to dissatisfaction among patients about their inability to see their GP after office hours.

Ben Bradshaw, minister for health services, said: “Every survey we do of the public about the health service has resulted in people saying their top priority, in terms of improving the health service, is better access to GPs.

“We do not think it is unreasonable that when taxpayers are investing record sums in GP services that they should be able to see a GP at a time that is convenient to them, in the evenings or at weekends.”

Bradshaw insists that the polyclinics in themselves will not cause the closure of GP surgeries. In some areas large health centres have existed for a long time without controversy.

GPs disagree and the BMA has launched a “save our surgeries” campaign. The ensuing row has escalated to the point where Alan Johnson, the health secretary, accused the BMA of “scaremongering” and putting the financial interests of GPs, who earn on average more than £110,000 a year, before patients’ interests.

“The controversy may well be caused by some GPs fearing greater choice for patients, worried that they themselves will lose out,” Johnson said.

Doctors have long guarded their independence and the dispute has been fuelled by the government’s aim of inviting private companies, including Virgin and Tesco, to run some of the “super-surgeries”. GPs claim such large companies will be able to make more economies of scale than traditional practices, putting smaller practices, particularly the 1,800 single-handed GPs, out of business.

Dr Laurence Buckman, chairman of the BMA’s GP committee, told a meeting of the union last week: “Voters don’t want funding to move from GP practices to commercial companies which are accountable primarily to shareholders rather than patients. They want to be treated as patients, not customers.”

The Conservatives stirred the debate further by claiming that placing a polyclinic in every primary care trust area will result in 1,091 family doctor surgeries shutting in London and 609 closing in the rest of England.

Andrew Lansley, the shadow health secretary, said: “We are not against the idea of polyclinics in some places, but not at the expense of local family doctors and patient care.

“Continuity of care for patients is at risk if their family doctor is closed and moved to a polyclinic. Patients will have further to travel and will be lucky to see the same GP twice.”

Others point out, however, that many GPs can now afford to work part-time, which means that patients often do not see the same doctor on every visit under the present system.

Independent experts have so far taken a middle view. The King’s Fund, a health think tank, has welcomed attempts to make GP services more convenient for patients, but warns that super-surgeries may be detrimental in rural areas if patients have to travel further to see GPs.

Niall Dickson, chief executive of the King’s Fund, said: “Our model of healthcare has changed little since the NHS began 60 years ago. Advances in technology, changes in the composition and working hours of staff, as well as patient expectations, all signal the need to review how and where care is delivered. The polyclinic approach may be one way to redesign services around the needs of patients. But we must not underestimate the amount of time, energy and resources that would be needed to make it work.”

Although the government insists that polyclinics will not be enforced in rural areas, some MPs remain sceptical. Mark Pritchard, Conservative MP for the Wrekin, a constituency which includes rural areas of Staffordshire, said: “Polyclinics would only be appropriate if they complement rather than compete with GP surgeries. This might well happen in large urban areas but it is much less likely in rural areas.”

He fears that eventually GP services may be cut back in the way that post offices are being closed down.

Among those concerned about the proposals is Nicola Alder who lives in rural Yelverton, on the edge of Dartmoor, Devon, with her husband and one-year-old daughter, Anna. Alder, 29, a nurse, said: “The threat of having a polyclinic rather than a GP was brought home to me when Anna fell ill. She was suffering from a chest infection but, thankfully for me, the doctor was justa short walk away.

“Because every time we visited the surgery we could see the same doctor, she knew exactly how much progress Anna had made and how to treat her until she was better.”

Disputes over the future of the family doctor are not going to go away. After London, PCTs across the country will have to decide where to introduce polyclinics.

Public split over one-stop health shops

What is a polyclinic?
A large “one-stop” health centre offering a wide range of services, open seven days a week, including evenings, and staffed by doctors working shifts

What are the government’s plans for them?
It intends to open an initial 150 polyclinics, with at least one in every primary care trust

Why are some patients opposed to them?
Patients worry they will lose the traditional relationship with a family doctor because they will not see the same doctor at each visit

Why do GPs object?
They fear commercial giants such as Boots and Tesco will run polyclinics. They fear that small practices will not be able to compete and the BMA has even claimed the government is trying to ‘break’ NHS general practice

A poll of nearly 1,800 people for The Sunday Times by YouGov last week shows the public is pretty evenly split over the issue:

Q. Do you support or oppose polyclinics?
Support 36% Oppose 42% Don’t know 22%

Of those in favour, 42% said they would still be in favour even if they had to travel further and could not be guaranteed to see the same GP on each visit. But 19% said they would prefer to keep their local GP surgery if this were the case, and 38% said it would depend how far they would have to travel and the range of services offered at the new polyclinic

Explore Health

• Expert Advice

• Health Features

• Mental Health

• Alternative Medicine

• Child Health

• Health Club