Polyclinics: a Soviet triumph

There can't be many New Labour policies that have Soviet origins. But the large scale health centres or polyclinics currently under discussion as part of Lord Darzi's proposals for the NHS in England do have very surprising historical roots. Polyclinics, which house GPs under the same roof as other medical professionals, have been discussed in British health care circles ever since 1920 when Lord Dawson wrote a report recommending a comprehensive health system. He suggested Britain might look more closely at how the new Soviet Union was organising its medical facilities.

Dawson, "the Darzi of his day", according to the leading medical historian Virginia Berridge, was taken seriously. Looking back now in the post-Soviet age, well aware of the gulag and the economic misery of Soviet life, it is hard to remember how fascinating this new society once seemed to many in the West. In the interwar years some

British polyclinics were created, especially in London, grouping together doctors' practices and other health care facilities.

But when many more were proposed as the NHS was founded in 1948, they fell foul of some doctors' fear that a national health service meant some kind of totalitarian takeover. Nazi rather than Soviet analogies were more popular with senior figures in the British Medical Association who opposed the creation of the NHS - one compared the minister of health to a 'medical Fuhrer'. But as opposition to Lord Darzi's latest version of the polyclinic idea has gathered steam, opposing doctors, keen to mobilise opposition from their patients, have been quick to remind their listeners of the original Soviet link.

The irony is that the Darzi version of polyclinics would probably have Soviet health kommissars spinning in their graves, as it offers a new route for private health care into