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Insiderperspective

What you are describing is a hospital of sorts - just one with no beds and either poorer quality diagnostics or duplicated diagnostics. And of course with some patients then facing being shunted between polyclinic and proper hospital.

The previous poster is correct. We now live in a faster world with greater convenience to the consumer and lower waits - next day delivery almost feels like too long to wait. We will increasingly expect the same instant availability and fast diagnosis from our health care systems.

How many of us now -particularly those of us who rarely go to a GP - research our symptoms beforehand and present tp a GP with a pretty good idea of what we need next, only to find that we know more about the possible diagnoses than the Doctor and have to wait patiently until he or she hits on the right course of action.

Why not turn around the current policy, which is failing miserably, and accept that primary care should focus on patients with existing diagnoses. Their aim should be to keep patients with chronic conditions and the elderly under review and as healthy as possible. The rest of us should be able to book to see an appropriate specialist via an NHS Direct style, symptoms based, booking web site and when we are ill but don't know who to see, should be encouraged to use expanded A & E services with polyclinic style annexes developed ASAP.

It will always be too expensive to provide the instant access patients will increasingly demand in GP surgeries. It shouldn't be unaffordable to cut out the middle man and provide excellent, easy access diagnostic centres adjacent to A&E.