Just before the Bank Holiday weekend I received, from something called "The NHS Confederation", a pamphlet entitled "Ideas from Lord Darzi;Polyclinics".

We are told that, following humiliation at ballot boxes around the Country and chastened by a lack of confidence shown by many but the most sycophantic of his own backbenchers, Prime Minister Brown is in listening mode.  Perhaps, therefore, he would like to consider what follows.

A group of Kent and Sussex Members of Parliament met, recently, with The South East Coast Strategic Health Authority.  This is the successor to the Kent Strategic Health Authority and in my view an equally costly and wholly unnecessary tier of NHS management. Nevertheless, as long as it is there we have to deal with it. At this meeting we were told that the term "polyclinics" had been dropped, in the teeth of hostility from the Patients` Association and the BMA, before the ink was dry on the document that landed on my doorstep.  The new buzz-phrase is "GP-led health centres", a term designed to placate those General Practitioners who saw Professor Lord Darzi’s proposals as a threat to their own territory and, presumably, to their incomes and resources.

The Strategic Health Authority told us that Polyclinics - sorry, "GP-led health centres" - are designed to "plug the gap where there are shortages in GP services".  Now, there is a genuine debate to be had about the merits of Group versus one-man practices, about hours of GP accessibility, about some practice premises and about out-of-hours services and that debate raises serious issues about public service that need to be urgently addressed.

I am not, however, aware of any gaping holes in the vacancies for General Practitioners in my constituency.  Off the top of my head some seven group practices have either built brand-new surgeries or fully re-furbished older ones in recent years and at least two more are looking to build and re-locate.  The complaints that I receive revolve to some extent around access but much more generally about the time taken to obtain a non-urgent appointment and the failings of that other government gimmick "NHS Direct".

Professor Lord Darzi is an eminent surgeon and, I am sure, very highly medically qualified.  His slender volume of proposals, however, while casting a passing glance at what he describes as "the future of relatively small district general hospitals and how they can play a wider role…..etc" seems to be based largely upon experiences gained in London. Birmingham, Liverpool and Sunderland.  I would therefore suggest that he now leaves the ivory tower and visits the Planet Earth that, in East Kent, most of my constituents inhabit.

The Ramsgate Hospital is, sadly, no longer with us but we still retain the Deal, Faversham, "Whit and Tank" and Queen Vic cottage hospitals as well as the Buckland in Dover.  Deal pioneered the use of telemedicine in the area and the Queen Vic has x-ray facilities and an operating theatre as well as land available for extensions..

I have spent many of my parliamentary years, under successive administrations, seeking to save our cottage hospitals and to promote their development in the interests of still-better providing for the communities that they serve.

There is much medicine that, GP and Nurse-practitioner led, could and should be offered much closer to home.  So, Mr. Brown, instead of backing yet another shiny new and potentially costly initiative from yet another commission, how about putting some real cash into enhancing the facilities that already exist in many localities and encouraging the General Practitioners to support and lead such a programme.  GP-led cottage hospitals really could make a difference and provide the "local healthcare for local people" that I believe my constituents want. 

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