Under proposals for a radical overhaul of healthcare in the capital, which the government could roll out across the UK, GPs will be encouraged to sell up and move into NHS-owned polyclinics, housing up to 10 practices.
In his report, 'Healthcare for London: a framework for action', published last week and commissioned by NHS London, the surgeon and junior health minister Professor Sir Ara Darzi describes current GP premises as 'often in cramped, converted residential spaces with little opportunity to expand'.
Polyclinics could house 25 GPs working alongside consultants. X-rays, ultrasound, blood tests and dialysis would all be provided, with hospitals concentrating on acute services.
Sir Ara hopes the first clinics will open by April 2009.
The report says polyclinics will offer 'extended opening hours across a wide range of services'.
APMS contractors would be welcome to bid if GP consortia were not interested in managing polyclinics.
NHS London said the capital was 'going to be a model for other areas' as they review primary care.
Londonwide LMCs secretary Dr Fay Wilson said: 'We're worried that they will do the downgrading hospitals bit without putting extra funds into primary care; that would leave us with a load of inefficient white elephants in London with GPs rattling around in pointless buildings.'
PCTs, she said, would have to buy out the old practices at considerable cost to entice GPs into polyclinics.
'This is short-sighted. We would lose all the quality derived from GPs having a vested interest in their practice.'
Dr Laurence Buckman, acting GPC chairman, said: 'To force people who are not naturally inclined to work in this way to do so against their wishes is not a recipe for success.'
But Sir Ara said although there are 'pockets of excellence' in general practice in London, variations in standards of care are 'shocking'.
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