Polyclinics will end traditional general practice in every area of the country, leading to factory-style care in supersized group practices, with no thought for continuity of patient care. That was the thinking that led GPs from Worcestershire to make a six hour round trip to 10 Downing Street to petition Gordon Brown against the policy last month.

Doctors believe that, in the senior echelons of the NHS, word has gone out that every primary care trust must have a polyclinic. Yet the Department of Health categorically denies a national policy of polyclinics. And even Lord Darzi himself told the House of Lords recently: “Those suggesting that I envisage the herding of GPs into polyclinics imposed from above have missed the whole tenor of my report, which is about ensuring that change is led from the bottom up by local clinicians.”[1] His words were echoed by a. departmental spokeswoman, who told the BMJ: “As Ara Darzi has said repeatedly since he started his Review, it is for local people and clinicians, not the Government, to decide what they want in their community as what works in one area might not be suitable for another.”

Yet the department of health announced last October—not long after Lord Darzi’s ideas were first aired—that it was ploughing £250 million into new health centres in every primary care trust, offering core GP services and possibly a range of other services such as dentistry and physiotherapy. There will be 152 new health centres and, for the areas with greatest needs, over 100 new GP practices, the department says.

Moreover, when going out to tender for these new health centres, primary care trusts are likely to use …