claims it costs an average of €50 a day to treat someone in a polyclinic compared with €350 a day to treat them in hospital.

And have any been established yet in the UK?
Yes. Under the NHS's 'Lift' programme, a type of private finance initiative, several 'supersurgeries' have been built. At the Brocklebank Health Centre in Wandsworth, for example, 15,000 patients under the care of 13 GPs have access to chiropody, speech therapy, anti-natal care, family planning, minor surgery, etc. But a report by the independent King's Fund into such schemes says the absence of clear local leadership often frustrates integrated care, so that long-standing divisions between GPs and specialists remain.

And do GPS favour polyclinics?
No. A poll in the doctors' magazine Pulse shows just 8 per cent say their area needs a polyclinic; one in three GPs would refuse to work in one. That's in part because many GPs fear competition from the big private companies that would run some of the new centres, and worry that they'd lose control over their practice's biggest asset - its building (a factor that explains why so many practices tend to be located in richer, leafier areas rather than where they are most needed). But GPs also have less self-interested grounds for concern. The BMA (the doctors' union) fears that the new clinics will force traditional GP practices to close and in the process destroy the personal link with (and proximity to) the family doctor that patients set such store by. And when big private companies run the polyclinics, says the BMA, patients won't get continuity of care, as the salaried doctors the companies employ are unlikely to stay in one place for any length of time. Meanwhile the Tories estimate that 1,700 of England's GP practices will have to go. But the Government accuses the BMA and the Tories of scaremongering and claims the new polyclinics will complement, not replace, existing practices.

So who is right?
It depends whether the new clinics follow the 'supersurgery' model, which involves dismantling existing GP surgeries and relocating their services in one big unit; or the 'hub and spoke' model, where most existing practices continue but share access to a set of new services in one facility. The King's Fund supports the 'hub and spoke' model, which would allow people to keep their family doctor (the 'spoke') while providing them with a 'hub' to handle diagnostics, unscheduled calls, and teams of specialists. But the thrust of Labour's plan seems to favour the supersurgery idea. NHS organisations in London already have plans to close more than 100 GP surgeries to make way for polyclinics. And though Health Secretary Alan Johnson insists GPs will stay in control, he is quietly binning a payment, the minimum practice income guarantee, designed to protect GPs operating alone.

But will the new polyclinics save money?
Junior health minister Lord Darzi insists that the polyclinics will be cheaper than the hospital care which they are intended to replace, and predicts that the NHS will be able to save around £1.5bn a year in London alone. But experts think this is highly questionable. The NHS will save money if hospitals strip out costs on overheads and activities being moved to polyclinics, but on past experience that's unlikely. Far more probable is that the new services will fail to reduce demand on hospitals and that their costs will supplement, rather than substitute, hospital costs.