The Government and the British Medical Association (BMA) are currently locked in debate over the size of GP surgeries, following the launch of polyclinics over a year ago, which cater for a range of health services, including health screening, maternity care, dental services, minor injuries and psychiatric services.

The BMA has opposed Lord Darzi’s vision for polyclinics to replace traditional GP surgeries, however, saying that they may prove too large to provide continuity of care for patients – and do not represent value for money in the NHS.

Figures from the GMC show that, in the last year, 17 solo GPs and 67 group practice GPs have been brought before a GMC ‘fitness to practice’ hearing.

NHS figures show that for the same period, there were 1,589 solo GPs and 38,728 GPs in group practices in England, Wales and Scotland, indicating a one in 100 chance of a solo GP coming before a disciplinary hearing annually, compared with a one in 600 chance for group practice GPs.

However, statistician Dr Michel Coleman of the London School of Hygiene and Tropical Medicine told the BBC that the figures for solo GPs might be the result of ‘some unconscious bias in the GMC process’ – or because single-practice GPs had no colleagues to confer with.

‘I have been a single-handed GP and I know how tough it is to deal with some of the acute crises that can occur if you don't have a colleague to refer to immediately,’ said Dr Coleman.

The NHS has encouraged solo GPs to join multiple practices in recent years, especially since the conviction for murder of single practice GP Harold Shipman.

One unnamed London health boss told Newsnight reporters that he was trying to ‘squeeze out’ GPs who work alone because they may not be up-to-date in their medical knowledge, may be reluctant to seek ‘help or advice’ – or might work from ‘unsuitable premises’.

Head of NHS London Ruth Carnall also said:

‘We're not forcing GPs to leave. But can single-handed practices provide the range of modern primary care and other services? The answer is “No”.

‘What isn't possible is the single-handed GP operating out of his front room. The ones which are going to close are the ones in crappy end-of-terrace houses where you can't park, get up the stairs or get a pram through the front door.’

BBC2’s Newsnight programme screened a full report into single practice GP disciplinary hearings on July 22, 2009.

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