Bigger isn’t necessarily better

We’ve lost our post offices, our police stations and our local shops, writes blogger Emma Suddaby. Our district hospitals have had to fight tooth and nail for survival and now it looks like our doctors’ surgeries are at risk too. Whatever happened to “If it ain’t broke, don’t fix it?”

Health Minister Lord Darzi has drawn up plans for a new generation of “super-surgeries” to be rolled out across the country, after trials in London.

These GP-led centres will incorporate all the normal services we visit the doctor for, plus new services normally provided in hospital, and with extended opening hours.

Sounds wonderful, doesn’t it? But the more we look into the way it will be provided, and the reality of what it will mean, the more worrying it becomes.

These proposals have been rumbling on for some time now within the halls of government, but the super-surgery is about to arrive in Shropshire.

Government promised these centres would be developed with “new money”, but the reality is that each primary care trust will be expected to find funds from existing budgets for a new health centre that, actually, nobody in Shropshire has asked for.

Local GPs deplore the moves. At a meeting of top family doctors, the secretary of the General Practitioners Committee for the West Midlands said that, despite reassurances that all change will be “locally led”, primary care trusts are being given no freedom to choose whether to open a new Darzi Health Centre, regardless of the need, or what the basic configuration of these centres will be.

He believes this lack of choice means PCTs cannot fulfil their legal duty of properly consulting with the public regarding the opening of a new, commercialised health centre with a guaranteed income which will undermine local existing practices and may face closure.

The running of these super-surgeries will be offered out to the private sector too, immediately setting up small existing practices in direct competition with large, outside multi-national companies. So it looks like the secretary might be right - local surgeries will struggle to compete.

The current plans for one polyclinic in Shrewsbury and two in Telford are going ahead and must be up and running by April 2009. You’d be forgiven for wondering why such a momentous decision was made about Shropshire folk’s needs on the results of trials based in London, where wants and needs are wholly different from those in more rural communities.

We’ve all had a bit of a moan about our GP service at some point, usually when we can’t get the appointment we wanted, but let’s not forget how brilliant it is when we really need it.

The NHS is a cradle-to-grave service. It helps bring us into the world, immunises us when we get here and then supports us through every stage of life, and eventually, death and most of those services will be provided by our family doctor. We build a relationship with our GP, and the value of that is almost priceless.

The role of a local doctor is not just that of a service provider. We trust our doctors with our problems, medical, emotional and ethical, because we trust that they know us well enough to protect our interests and help us solve those problems.

Will we still feel as protected when we are visiting a super-surgery, where the doctors are merely employees of a large, multi-national company, following company protocol rather than their own professional convictions? Where we might very well be able to have minor surgeries and such performed in-house, but where we will be very lucky indeed to see the same doctor twice . . .?

Perhaps the most worrying aspect of Darzi’s proposals is the seemingly stealthy implementation of his decisions. Work on the Shrewsbury and Telford super-surgeries must be under way by April next year - have you been asked how you’d feel about it?

Were you aware of the significance of these plans, and how a new super-surgery in your area might affect the GP service you currently receive? No, didn’t think so.

• Inspirational Emma Suddaby shares her ” highs, lows - and various murky places inbetween” - with her blog. Emma, a finalist in the 2007 Shropshire Star Woman of the Year competition, was diagnosed with aggressive, destructive rheumatoid arthritis at the age of 22. She later won a dream flying scholarship with the charity Flying Scholarships for the Disabled and now holds a National Private Pilot’s Licence.