POLYCLINICS!! I say the government should get STUFFED.
Why upset Doctors surgeries? I have a good GP surgery and would be very upset to loose them. I am disabled and cannot get about, so what happens if these polyclinics are introduced, does this mean, disabled people dont get GP services.

patrica lewis-cook, Dover, Kent

NO chage!!!!! i love my practice and would not want a change.. why does the Gov waste so much money for things that are working well....

Kourosh, Barnett, UK

Another small step in dismantling NHS. Still world leader.

When will the NHS fund health related charities supporting cancer patients? Some charities offer free services, which are highlighted in NICE report, to C patients, If charities cease to function C patients wil be even more isolated.

Jill Miller, Frome, England

I disagree with the proposals for "polyclinics" in this country.We have a unique system and its called the NHS which was set up to provide free health care for the people of England. Money should be spent there and not on WHITE ELEPHANTS which is what these clinics will turn out to be.

Anna, Stockport cheshire,

GPs are vastly overpaid need to work 5-day shifts to inc w/e).

A nurse can look up the National Formulary and do the same prescribing. Most ailments don't require a fully trained doctor.

Until recently GPs advocated seeing any one in the practice - now changed to 'have your own doctor' - so cheap!

Charles, Instow, UK

Lord Dazi is trying to create a solution for a problem that does not exist! I do not think he has ever heard the phrase "If its not broke, Don't fix it!"

As a pharmacist, I would like to see him work in a Pharmacy and actually how many of the patients would actually welcome his proposals.

Ravi Patel, London, UK

Patients like to see their own GP who knows their personal medical history. The thought of being one of a large group of patients, waiting to see an unknown Dr is frightening. And for any thing that needs further investigation or surgery patients like to have a consultation with a Consultant at a hospital.

marianne luxton, harrow , middlesex

This is abnother way of channeling money into the private sector rather than concentrating on incremental evidence-based improvements in primary care as it exists. bizarre if it wasn't so tragic.

Mark Oliver, Stafford,

As amused as i am by the wit of the put downs of nurses doing minor surgery I have to say that as a young GP I have met 2 nurse specialist who do just this. They are extremely good at what they do and have studied hard to gain background qualifications in skin condtions to inform their work. The important thing is that they work within a GP practice that they have been part of for years, and it was within this local setting the decision to allocate resources (money, loss of clinic time for training etc) to train these particular people was made.

jo, Essex, Uk

John Sinclair, minor surgery isn't all that difficult, not much more than peeling an orange. If you believe a nurse can do it, why so can you. Just get the appropriate Haynes' textbook on minor surgery, follow the diagrams - there you go - saved yourself the time and trouble of a visit to the polyclinic. Since you're doing the job yourself you can be sure it will be a good one - enlightened self interest. If it's in a place you can't reach, get a friend to help. After all, why should we pay a nurse to do it if it can be a DIY job.

You my fellow human being, are a good example of the proverb - 'A little knowledge is a dangerous thing'. If nurses are to become surgeons, they need to train as surgeons. If they train and qualify as surgeons, they will need to be paid as surgeons. If they want to become physicians, let them train to be physicians. If they want to be nurses, let them train as nurses, work as nurses and be paid as nurses

Bill Q, Derby,

I totally agree John Sinclair, Dundee, UK. The sooner we can get nurses doing surgery and the sooner we can get air hostesses flying aeroplanes the happier and richer we will all be.

Nick Barlow, Oslo, Norway

Let Darzi stick to tailoring, and stop interfering with our NHS

John Havelock Girling, Sherborne,

the public, the physicians and the long term experts will not be heard in this argument, whether large polyclinics or small practices, if something is working in a community with brilliant doctors multitasking for the good of the public, that will be ignored and equally if a rogue practice is providing diabolical care causing a stacking up of unnecessary admissions to an overstretched casualty unit, that too will be ignored, fitness to practice is not working, praise is acknowledged but not complaint.

mary foord brown, suffolk coastal,

Why is it that the government have now decided to adopt the 'big is beautiful' approach. The idea has been taken from the old soviet model where primary care services were offered by large factory-like polyclinics where patients were shunted from one clinician to another and the traditional doctor-patient relationship which we have taken for granted in the UK was non existent. Large polyclinics will alienate patients and will be the final nail in the coffin for the friendly family phsycian who knows and understands the health needs of each member of the family.

J Finnigan, Birmingham, United Kingdom

This might reduce the 'pill giving in the eight minute time slot' appointment approach.

Romans Seja, Billesdon, UK

This is nothing new but of course doctors don't like them because nurses start to do much of what doctors used to do and the question then arises why is a doctor paid over five times more? The sooner we get more police typing done by typists and more minor surgery done by nurses the sooner we can employ fewer police and fewer doctors and that is exactly why it won't be allowed to happen, not to "save the public" but to save police and doctor's jobs. Pathetic is the word for it. We need cheaper and far more effective public services and if those working in them don't like that then they should get out of them and try private work with none of the freebies such as cheap police housing or subsidised surgery improvements etc.

John Sinclair, Dundee, UK

This is an excellent proposal. It will be a welcome relief to the mess called NHS. As a doctor myself who works in a Hospital, this will improve the conditions currently dogging the NHS.

Vivek, London, UK

This Govt just can't stop tinkering with the NHS can it. It's an obsession with them. This idea was obviously dreamt up by some numpty in the Treasury with an MBA and strong links to the City which as we speak will be working out how to make money out of this.

I'm just hugely grateful I live in Scotland where the chances of such an idea being brought in are absolutely zero.

DickW, Aberdeenshire,

I write from the States. We passed through our "multi-specialty clinic (polyclinic to Dr. Darsi) phase years ago. Most of these clinics have been absorbed by HMOs and abandoned by their original physicians. They now specialize in low cost, mass-produced medical care delivered by 3rd world physicians to patients at great profit to their HMO owners.

The polyclinic ruminations of Lord Darsi, a laryngospasm-inducing title to any American), have some fatal flaws. First, and most important, they fail to take into account the desires or needs of the British peope for their own health care. My prescription as a fellow physician to Dr. Darsi: please forget about your political ambitions and limit yourself to taking care of your patients. You are completely out of your specialty!

Dr. Albert, MD, JD, MBA , LA, USA

'The consultants need to be at the coal face , not juggling with their private work diaries' someone wrote.
It is this sort of ignorance that is destabilising the argument. The NHS work is not done at the whim of the Consultant, i.e. when their private diaries allow. Consultants have fixed committments within the NHS - a set number of outpatient clinics and a set number of operating lists [if they are surgeons] per week.

wilson, London, UK

Lord Darzi is a super-specialist with zero experience of general practice. In addition he has not even had the courtesy or sense to consult anyone in the front line of general practice before coming out with this half-baked idea. The agenda here is to hive off GP to private companies. Comparing this with an experience in Spain is to miss the point. No one knows the tourist on a holiday. Your GP here does know you, and that is one of the strengths of general practice in the UK. This model does not work in other Western countries such as Canada or Australia. The strength of British GP is the personal relationship between patient and doctor. Say "Goodbye" to that and hullo to "doc in a box"!
Healthcare is, in fact, something that largely happens in daytime hours. Out of hours care is a small fraction of patient/doctor contacts. The government's own biased survey failed to show a demand for late opening, but they are pushing it ahead anyway. So much for negotiations in good faith.

Ian Campbell, Fife, Scotland

Most people love their GP? I do not spend more than five minutes with mine each time I see him. It's hardly sufficient time to develop a working relationship.

In France, each consultation takes at least fifteen minutes.

Jacques de Villiers, London,

I don't think its a good idea. We have them here in Australia. GP's, visiting specialists, chemist, podiatry, dentist, dietician pathology, x-ray and treatment room for stitches etc under one roof. No appointments, you just turn up and wait your turn. The Government pays for GP visits. The doctors can and often see 75 people per day over 12 hours. 75 per day is the AMA limit. One doctor that I know of has put a note in the office to say that due to the high number of patients that come in, he can only deal with one health issue per visit. I don't go to these as I see it as a sausage factory and the risk of mistakes is just too high. The temptation to just write a script to get rid of the patient is also too high. The managers of these centres are behind the push for such a high turnover. They keep half of all the money generated.

Ann, Adelaide, South Australia

The government is bent on destroying its own establishment. Somebody tell me what is wrong with the hospitals that we now need specialist in surgeries? What will become of the GP, will they be forced to re-train as it appears their services will not be needed?

Debbie O, Kent, England

I feel another PFI coming on!

Graham, Manchester, England

The Netherlands have something similar in the main cities though not with GPs in the same buildings. They act as a half way between GP and hospital and very good they are too with quick and efficient service though British managers will probably make sure that doesn't happen in the UK.

B Redfern, Amsterdam, Netherlands

So bang goes the local surgery to be replaced by large impersonal polyclinics where a person is unlikely to see the same doctor twice and be situated no doubt much farther away from many patients making it necessary for longer journeys to see the doctor and for some not on a bus route requiring a sometimes long walk to a bus stop or having to use a taxi (not everyone has a car). just great when a person is feeling ill. As it is it is difficult getting a home visit, receptionists ask a myriad of questions before putting someone on the list, it is likely to be even harder with a polyclinic,more stone walling and being passed from one person to another, I can just imagine it, bigger organisation less personal patient care. More mistakes and it will be the patients that suffer. No thank you Mr Darsi, go peddle your ideas somewhere else.

Patricia Kenny, Braford, West Yorkshire

My families old GP, who we had been registered with for 15+ years, moved into a large newly built health centre containing 6 seperate practices with additional services such as pharmacy, physiotherapy etc three years ago. Unfortunately the quality of care and service we received dropped dramatically. We therefore choose to move to a smaller 3 GP practice with a much improved personal service. The government should think very carefully before introducing another of Lord Darzi's mad ideas.
What works in some areas of London is not necessarily transferable to other areas of the country.

Karen, Birmingham, England

Lord Darzi did NOT say, as you quote, "we need to support that fantastic relationship between a patient and a doctor".

If you watch the video on the BBC website, what he actually said was:

"we need to SEPARATE that fantastic relationship between a patient and a doctor..."

Subtle difference!

Goodbye to continuity of care

T Martin, Wells, UK

It is important that local communities have full impact assessments when 'super-surgeries' or polyclinics are proposed. Currently 99% of the population can access healthcare advice from a local pharmacy. Centralising services could put the national network of pharmacies at risk. That's why it is important for the full picture - to include transport and social impact assessments to be made. The less mobile, the elderly, parents and carers could all have to travel further - and the viability of local shopping parades could be further put at risk.

Hemant Patel, President
Royal Pharmaceutical Society

Hemant Patel, London,

The government simply want the GP to be just another employee who can be told what to do ["evidence based", i.e. rationing] and when to do it. If Virgin employ them, then they and their pensions are off the payroll. Job done.

It is nothing to do with providing a service. We have all heard the lies before again and again.

wilson, London, UK

We have a system inplace now called home care but it is underfunded and more and more patients are transferred to the private sector and these elderly have to pay for the privalidge, so I see this as another poorly thought out strategy by pen pushers who have no concept as to what goes on in the outside world.
I have voted labour all my life but this labour goverment are a complete joke it was bad enough with Blair but this guy has not got a clue he has surrounded himself with a cabinet of chancers you only have to listen to them on tv I ask you would you buy a car from them.

Andrew Irvine, Stonehouse, UK

Why is it that no-one learns from the disaster that is HMO practise in the US? For another thing, just because something may work in the microcosm of London, does not make it applicable to the rest of the country. London is an awful model.
A Doctor

A Doctor, Shrewsbury, UK

It is not a nationwide solution but if done properly ,could stop the consultants'diary filling merry go round we have at the moment .
A polyclinic with a broad range of expertise behind the scenes would free up a lot of hospital space and reduce the anxiety felt by some , between diagnosis and treatment as a lot of the treatment would be carried out on the spot.
A recent visit to a similar polyclinic in Spain had my wife seen , diagnosed and treated in a morning , something that would have taken a few months in the N.H.S with the present referral system .
The consultants need to be at the coal face , not juggling with their private work diaries.
Expect a lot of opposition to this from within the N.H.S.
If for whatever reasons a waiting list is created 'surely it would just get longer and longer but it doesn't, it stays just long enough to keep the consultants in their offices and not in the wards.

Nick Dixon, Sutton Coldfield, England

Polyclinics are not the answer. What will happen if GP's provide continued obstruction to providing what patient's are asking for - ie flexible practice times/online booking systems etc; then polyclinics will be forced in. Healthcare is not a 8 - 6pm problem and the sooner that GP's recognise this and put their patients and not their bank managers first.

Peter Bull, Ossett,

Polyclinics have been a success in the UAE and Saudi Arabia for 20 years! I bet the UK will do it wrong. recent history suggests the NHS is still run by bumbling buffons who have spent more money than WW2 cost. Its very sad.

Andy, London,

I am afraid this was inevitable. Lord Darzi is an academic surgeon from a London hospital with London centric ideas, and a surgical mentality. He only sees patients who have things obviously wrong with them -ie need surgery. Most patients have problems and concerns about their health. Some will have nothing physically wrong, some chronic illness, and some with something basic that needs surgery and would get on a medical TV documentary that Lord Darsi or his colleagues could star in.. Poly clinics will debase the personal aspects of clinical medicine, and reduce people to easily counted government statistics. The NHS has depersonalised consultant practice , and now want s to do the same to GP's. Watch out!

Duncan, Kent, UK

Lord Darzi was interviewed on the BBC News this morning Saturday. He said that medical practice in Britain is the best in the world. Is it? He also said that in Britain and other developed worlds it was unique. And, is it not enough to address this world, let alone parallel universes? In how many places can you have something that is unique?

Clearly Lord Darzi is so focussed on spin that he has become brain dead. If we have polyclinics, then will the result be people like him running them?

Stephen Felce, Enfield, UK