The Conservative Party candidate for Mayor of London, Boris Johnson, has voiced scepticism over Lord Darzi's proposed "polyclinics" and has suggested patients' relationships with GPs could be damaged.
Mr Johnson said: "There is nothing in the Darzi report about public health – indeed, there is a real risk that the £3bn he proposes to spend on polyclinics could divert funds away from public health.
"It is the job of the Mayor to ask whether we are in danger of interrupting the link between patients and their GPs."
Mr Johnson made the comments in a speech at the Policy Exchange, in which he announced his proposal to reform the London Health Commission – set up by London Mayor Ken Livingstone in 2000 – and ring‐fence London's spending on public health.
Speaking on the subject of London's health inequalities, Mr Johnson said: "We have 57% of the cases of HIV, and as many as 27% of those infected may not be diagnosed. One million Londoners have had mental health problems. One in four drug users live in London.
"And London has higher rates of obesity than the rest of England, accounting for the deaths of 4,000 Londoners every year.
"It is a scandal that if you travel eight stops on the Jubilee Line, from Westminster to Canning Town, the average life expectancy of the surrounding communities declines by eight years. That is as great as the difference in life expectancy between Britain and Lebanon.
"In 2006, the Association of Directors of Public Health conducted a snapshot survey of 24 London PCTs, and found that only one pound in every six that was notionally allocated to public health was actually being spent on any such programme.
"That is why I am today proposing that we ring‐fence London's spending on public health and we reform the existing London Health Commission, set up by the Mayor in 2000, and give that body some meaning and some purpose; namely to work with the Mayor's office and with the boroughs to wage war against this inequality."
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"Taking the traditional family doctors away from the neighbourhood and amalgamating them in a polyclinic, which replicates services provided in the local hospital, can only be a politician's idea of common sense. This is another way of introducing private sector operators to cherry pick the "easy" procedures from the NHS, and threaten both hospitals and GP services. The public are being told this is for their own good and won't be aware of the sleight of hand until it is too late" – Name and address supplied
"100% behind Boris. Exactly how will an elderly person travel 10 miles to their nearest polyclinic, whereas presently they can access a doctor usually within walking distance? The polyclinics will take away the close relationship patients have with their doctors, and this is an important factor to a person's wellbeing" – Name and address supplied
"Polyclinics may be a suitable arrangement in some areas but a blanket policy of creating them regardless of local conditions will bring duplication and waste, and undermine local services, including GPs, public health and hospitals. I can't help wondering what private providers are doing in the background to prepare to cherry-pick profitable areas from the NHS and leave us with a fragmented and under-resourced service in so many ways. They must be rubbing their hands with glee!" – Name and address supplied
"This idea is definitely based upon the polyclinics of the third world countries, where there is no sound health system and such clinics tend to make access to healthcare more accessible. In Britain, we already have a very well established health system – the NHS. Every effort should be to ensure that the system is improved rather than abolished in favour of something which does not fit our bill" – Name and address supplied
"I totally agree with Boris's views on public health. The "Choosing health" monies were all swallowed up with the NHS deficit. London has a huge health divide, and affects the wellbeing of the whole area. True partnership working is what is needed. Westminster are ahead of the game anyway, as they have created joint posts across the PCT and council, but more needs to be done" – Alison Wall, Health Visitor, Herts