A London network of private GP outlets is to be extended to other parts of the country. It is attractive to patients and doctors. But is it elitist? Barbara Millar reports

GP recruitment difficulties hit a high in 1997, but this year could be worse if plans to extend the Medicentre network of private GP 'outlets' goes ahead.

The Medicentres, run by Sinclair Montrose Healthcare, currently exist only on three London sites - two at Victoria station and one at Euston. But, according to chief operating officer John Cariss, six or seven more should be up and running early in the year, with numbers burgeoning to 24 by next Christmas.

Most will be concentrated in Greater London and the South East, although Sheffield, Newcastle and Dudley in the West Midlands are also targeted, and could be followed by Northampton and Manchester.

The salary package offered could prove extremely tempting to young GPs. The company has been accused of trying to 'bring Harley Street to the high street', says Mr Cariss. 'But we are not trying to create an elitist or an expensive service. We want to make Medicentres a classless product.'

The pilot Medicentre was set up at Victoria station just 15 months ago with one GP consulting room. A 15-minute consultation costs pounds36. About 85 per cent of users are commuters, and 15 per cent are overseas visitors.

'People consult the Medicentre GP for the usual broad range of problems which they would take to their NHS GP, although ENT problems, particularly respiratory diseases, make up the highest numbers,' Mr Cariss says.

'The service we offer is highly accessible - there are no appointments - and very convenient. Our opening hours are 7am-9pm Monday to Friday and 9am-5pm on Saturdays.'

The expansion in the number of Medicentre outlets is accompanied by an increase in the services offered, including executive health screening, lifestyle health checks, well woman and well man checks, including prostate screening, travel programmes and diagnostic and pathology tests.

'We want to be a one-stop shop,' says Mr Cariss. 'It may be that some people will not come to us for their initial consultation, they may go to their own GP. But, if they need a range of pathology tests, they may find it more convenient to have them done at a Medicentre rather than their local hospital.'

Mr Cariss is keen to move Medicentres into shopping centres. Two of the new outlets will open in London's Oxford Street, one is scheduled for Sainsbury's Archer Road superstore in Sheffield, and others are planned for the Metro Centre in Gateshead and the Merry Hill Centre in Dudley.

Negotiations are also under way with the British Airports Authority, with the idea of opening a Medicentre in Heathrow and Gatwick.

'More than 70,000 employees operate out of Heathrow. There is a huge amount of international traffic and BAA only takes the best of brands,' says Mr Cariss. 'To move into these areas would be very good for us.'

'Brand prominence' is important for Mr Cariss, a former retail manager who started his career with Great Universal Stores before moving into the NHS as an IT manager with Tower Hamlets health authority. He left the health service in 1991, quitting a general manager's job with St Helier trust in Carshalton.

'Our outlets are modern - no leather chairs or wood panelling. They are high quality and fit in with people's busy lifestyles,' he says. 'But we are not trying to duplicate NHS services.

'There are many things the NHS does extremely well, and most people are generally satisfied with the medical treatment they are given by their GP. But some things need more of a mixed economy.

'Our research has shown that people are dissatisfied with waiting for appointments, accessibility and waiting in surgery. We believe people want more choice in primary care and will be prepared to pay for it.'

According to his company's research, 42 per cent of people are prepared to pay for a 'no wait' GP service and 47 per cent would use a private service instead or as well as the NHS.

More than 10,000 patients have used the service at Victoria and repeat business is running at 15 per cent and growing, he adds.

Carole Lawrence-Parr, chair of the Association of Managers in General Practice, agrees that Medicentres appear to serve a need for commuters who want an instant consultation with a doctor, at a convenient time and place.

'Perhaps this is a signal for more companies to provide occupational health services in the workplace,' she suggests.

But as well as attracting patients, the service is also appealing to GPs, particularly 'youngish GPs with some experience, who do not want the overheads of a practice, the administrative workload, a 24-hour responsibility and all the rest of the stresses and strains', says Mr Cariss.

'What they get from us is a high-quality environment in which to practise medicine and they are well supported by clinical support services.'

They are also paid between pounds45,000 and pounds55,000 for a 40-hour week, although they will be expected to participate in the 24-hour services the Medicentres hope to offer as they develop.

'This will not help the recruitment situation in primary care,' warns Ms Lawrence-Parr. 'But, from a patient's point of view, there is obviously a need which primary care will have to address.'

Other services which can support NHS GPs are also in the pipeline, including cover for GP co-operatives and space in Medicentre's shopping centre outlets for GPs to run satellite surgeries on Saturdays, 'providing more convenience for their patients and allowing them to run more product lines', says Mr Cariss.

He also hopes to offer GPs the opportunity to do private work through Medicentres, in the same way as NHS consultants can operate in hospitals.

'We do not want to be seen as an alien concept or a threat,' he stresses. 'We want to be positioned alongside mainstream GPs.'

The company has 'a substantial amount of private capital' behind it. It raised pounds7m for capital development when it was floated on the Alternative Investment Market of the London Stock Exchange and there is an 'enormous interest' from the city in the Medicentre product, says Mr Cariss.

Insurance firm Norwich Union has also invested in the company and together they are developing a primary care insurance product which should be launched early next year.

It will offer 'the whole range of services you would expect to receive from a GP, at an affordable price', says Mr Cariss. 'It will not be expensive.'