Leader: Pile the GPs high and sell them off cheaply?

These days you can reinsure your car and change your electricity supplier while popping into Tesco for a pint of milk, a Playstation and a DVD. But what about a scrip for antibiotics and a quick wart removal? 'GPs at Tesco' is how DoH officials have attempted to explain the White Paper plans to increase access to primary care.

There are two levels to these plans. The idea of co-location with large retailers or other businesses providing sites for surgeries is straightforward.

It has worked in the past and ensures surgeries are near parking and on major bus routes. However, the notion that Tesco might bid for alternative provider contracts and employ GPs to provide NHS services from their stores seems more far-fetched.

The supermarket is being held up as a business that can do anything but, however wide its range of services, they are all, at heart, retail operations. Even its 'legal services' boil down to DIY will kits. General practice is a very different trolley of goods. Pile it high and sell it cheap doesn't work for a queue of pensioners seeking statins or BP checks. General practices are service-orientated, specialist businesses where high throughput does not necessarily mean high profits.

A major factor in the access issue is the shortage of GPs. Where are the alternative providers to find their doctors, as well as their nurses and expert practice managers? Primary care czar Dr David Colin-Thome said GPs might be keen to work for Tesco. But will it really offer the salaries to attract partners away from their own practices or even busy locums - surely that would cut profits?

Whatever the White Paper says, the answers to increased access to GPs have not changed - train more GPs and increase investment to build new premises. Then the experts in primary care can offer access to the services their communities need.

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