Shortage of medical services? No problem! Just move the same doctors into different buildings!

The British looniess is unending

Pharmacies could be given powers to offer GP services under plans drawn up by Tony Blair's health policy adviser. Doctors could run surgeries at Boots or other private providers, such as BUPA, at times and places more convenient to patients, Paul Corrigan said in a report published yesterday. Professor Corrigan believes that GP practices are already like small businesses so to extend their services from conventional surgeries to other private settings is a logical step. Patients should be able to petition for new-style surgeries in areas where many GPs' lists are full, he has suggested.

He was recruited to No 10 as Mr Blair's most senior health adviser last month after completing his pamphlet for the Social Market Foundation think-tank on reforming GP practices. In the report he said: "There are claims that any extension of primary care services to new independent sector providers would in some way mean a privatisation of primary care. "From 1948, primary care has been developed through a private sector model. In this sense, primary care is already privatised, and so it is politically very sloppy to see the entry of another form of private enterprise into the primary care market as privatisation." He said that it was important to make innovative changes to achieve the "significant shift of activity from secondary to primary care" necessary to achieve the target of a maximum wait of 18 weeks for an operation by 2008.

Professor Corrigan, the husband of Hilary Armstrong, the Government's Chief Whip, and a former special adviser to the Department of Health, added that foundation hospitals could also host GPs. He believes that pharmacies and private companies can offer more services, such as injections, that are traditionally the domain of the GP. But GPs, whether working in a pharmacy or conventional surgery, would retain the power to refer patients to hospital.

Sources said that Professor Corrigan's ideas would need Treasury and Cabinet approval before becoming policy. The British Medical Association said that the fundamental problem was not flexible opening hours but a shortage of doctors. Hamish Meldrum, a GP spokesman, said: "Our fear with too great a diversity of alternative providers is that you get fragmentation, which causes problems of continuity of care."

Ann Rossiter, director of the Social Market Foundation, said: "The Government must take this report's proposals seriously if it expects to create a patient-centred NHS where care is organised to respond to our needs and at our convenience." Patricia Hewitt, the Health Secretary, has already said that GP surgeries should extend their opening hours into the evening and weekends if that is what local people want.

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