For anyone from the former Soviet bloc—and there are quite a few doctors from the new member states of the European Union now working in the United Kingdom—the current discussion about the introduction of polyclinics in the English NHS must be utterly perplexing. Polyclinics were a centrepiece of the Soviet model of healthcare delivery, but many countries of Central and Eastern Europe have abandoned them over the past two decades in favour of a system of general practice that draws extensively on the British model. Advisers from the World Bank, the EU, and many bilateral donors agreed that the polyclinic had failed to deliver modern, integrated health care and saw general practices as the future. How can it be that England is now introducing a model that countries in Central and Eastern Europe were so recently encouraged to give up?

Although there is still considerable debate about what an English polyclinic might look like,1 they will share with their …