A White Paper out today will pave the way for super-surgeries, combining family doctor services, out-patient clinics, small surgical operations and other services under one roof. It will be followed by legislation to be published with the Queen's Speech next week.
A leaked background document for the Bill, which The Independent has obtained, shows that ministers plan to allow a wide definition of those who may offer GP services in pilot schemes. It says any GP practice or "other organisation" may apply to provide personal medical services.
A Government source said: "We would not foresee any great numbers of pilot schemes involving commercial organisations but don't rule it out altogether. The aim is to let a thousand flowers bloom."
There may be attractions to allowing one-stop centres to open in shopping malls, for the convenience of patients. But ministerial sources were adamant there will be no breach in the commitment to maintain the NHS as a free service paid for by taxation. The patients will not be charged, although the operators would be allocated NHS funds to open the surgeries.
The White Paper, to be announced to the Commons by Stephen Dorrell, Secretary of State for Health, will also let hospital trusts employ GPs to provide family doctor services in areas where GP cover is poor.
Chris Smith, Labour's health spokesman, called on Mr Dorrell to give a guarantee that it would not lead to commercial operators being allowed to offer GP services in the High Street, for which patients may have to pay. "Mr Dorrell must come clean over whether he wants to see GP services franchised out to organisations like retailers or pharmaceutical companies," Mr Smith said.
Ministerial sources confirmed last night that it was the intention to remove obstacles to flexibility.
A private surgery was opened recently at Victoria station, London, where patients are charged pounds 32 a time. Denying it would be the model for further surgeries, a Government source said: "The Victoria surgery is entirely private. It is completely outwith these proposals."
John Major last week reaffirmed the Tories' commitment to the NHS, ruling out charging for treatment, but the influential right-wing think tank, the Adam Smith Institute, published a report calling for a "core curriculum" in NHS cover and for "top up" provision through insurance.
Mr Dorrell believes his White Paper will put Labour on the defensive over health. It promises to build on the successes in the GP fundholding system, which Labour is committed to replacing with a cooperative system under which family doctors would work together to stop queue-jumping.Reuse content