Lord Darzi has insisted that no GP surgeries will close as a result of the controversial new polyclinics, adding that there had been "confusion" about his plan.
Answering the Tories' claims that up to 1,700 surgeries could be at risk, the health minister said no existing practices would be forced to shut as a result of the 150 new GP-led centres planned for England.
The British Medical Association has warned the plans will depersonalise care, while critics have claimed the new clinics will be imposed on areas where there is no need for them and that the money could be better spent by local primary care trusts (PCTs).
Lord Darzi told BBC1's Andrew Marr Show: "We are talking about 150 new health centres across the country. This is additional money, this is not replacing current practices." He insisted that surgeries would not close, adding that the new centres would be in addition to existing facilities rather than replacing them.
A GP-led centre will be built in every English PCT under the £250m plans. The centres will operate a "walk-in" service and patients will be able to stay registered with their existing family practice.
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"A walk-in centre that does not have a requirement to build up a registered list would not be a threat to existing practices. However, if you look at the procurement documents on the DH website, you can see that the GP-led health centres are required to have registered patients (in addition to walk-in services). Also, they have to include in their bids a description of their marketing strategy and of how they will seek to build up their patient lists. Once they are in place it will be in the interests of PCTs to encourage patients to move across since then they would not have to pay existing practices. This cannot fail to damage existing services. In those areas (allegedly 'under-doctored') selected for additional practices this effect will be magnified. The net result will not be more doctors, just different ones. It might be acceptable to turn to the private sector for support in areas where there a large number of unregistered patients but this wholesale introduction of commercial competition cannot be dressed up as anything other than deliberate 'privatisation'. It is not value for money nor is it likely to be effective in reducing health inequalities (since the sickest patients are those who frequently attend their GP surgeries and most value continuity). If the public really knew what was going on these reforms would be as popular as the abolition of the 10p tax rate" – Pat Laurence, Lancs
"I am concerned by statements that patients can attend the new access centres and maintain their registration with their own practice. This may be all right for blood tests and acute problems. But if we have both doctors in the access centre and their GP managing chronic conditionds this is surely a recipe for disaster. If, however, it is only acute problems and tests the access centre just becomes a walk-in centre and we have one of those already" – Allan Stewart, Wirral