Professor Tom O'Dowd:

On the walk-in, we cannot be overly romantic about general practice. No doubt my children, who are young adults, and others are not terribly interested in having a relationship with a GP because they want to go in for what they want, they want to be seen on time, they want it to be reasonable and they want to leave. However, that is the demographic that suits the walk-in. Many of the walk-in clinics are based on that business.

Once people start having children themselves or once they start developing illnesses, they want a trusted person who, as the Law Society says, is in their corner. They very much need that. Because the hospitals have become so difficult, one needs somebody who is able to advocate on one's behalf for the local hospital. Sad and all as it is, one needs that.

On corporatisation, I have seen some of my colleagues who have been corporatised and I must say they looked much better than I did when they had done the deal. However, I cannot say that it is good for general practice because the very nature of a corporation is that one can be bought and sold. If one is sold on to another corporation which wants the practice done differently and always cheaper, and it will have shareholders, it takes stuff out of the system. It is a tricky area. Corporatisation is small at present. We measured it in our last survey of general practice. It is growing because I see it growing on the ground.

There are strong defenders of the corporate system. I have read what some of those who are employed by the corporates say. I am also aware of somebody who has left a corporate system because she did not like it. It is not for everybody. The big issue is it introduces another instability into the business model of general practice.

For the rural areas, it is only a matter of time from what I can see, if we are having difficulty appointing rural doctors, until there is a corporate response with GPs moving in for particular times during the day and moving out. People will want doctors in rural areas but if our current GP registrars and trainees do not want to work in single-handed practices, we cannot square that circle. It leaves patients vulnerable. If corporatisation gets a view on it and if they copy, say, an Australian model that works, then it introduces yet another vulnerability.