unclear whether polyclinics would be funded in addition to existing GP services or whether they will take funding away from existing practices. Although Lord Darzi claimed that their funding would be in addition to existing funding, following the publication of his report, eight London primary care trusts drew up plans to relocate more than 100 urban GP surgeries into polyclinics. The Conservative Party claimed that unless existing surgeries close, polyclinics will leave a £1.4 billion "black hole" in public finances. Implementation Polyclinics were originally planned for and implemented in London, with every primary care trust in the country subsequently required to have at least one new "GP-led health centre". All of the first wave of polyclinics in London, which formed a pilot of the model, were of the federated/networked model and involved "existing services working more closely together". As of August 2008, more than a quarter of PCTs had plans to implement a polyclinic or GP-led health centre, including Birmingham, Cumbria, Lincolnshire, Rochdale, Cheshire, Essex and Bolton. More than 50 PCTs admitted that they would not consult local communities over plans to build polyclinics, some citing advice from the Department of Health as the reason, despite repeated government promises that they would not be introduced without consultation. The country-wide rollout of GP-led health centres was criticised by doctors' leaders and patient groups. Dr. Richard Vautrey, deputy chairman of the BMA, called it "a government plan that is potentially going to waste hundreds of millions of pounds of scarce NHS resources, creating very large health centres that many areas of the country simply don't need or want", while the Patients Association noted that gathering services under one roof in rural areas "may actually put patients at risk" and noted that rural patients already had to travel further and were more reliant on primary care. The other political parties have also criticised it, with the leader of the Liberal Democrats Nick Clegg calling it "the central imposition of a polyclinic on every primary care trust, regardless of the geography, demographics and clinical needs of the area" while acknowledging that they might be a good thing for people in some communities and Conservative leader David Cameron suggesting large-scale closures of existing GP surgeries. The results of a freedom of information request by Pulse on the plans for polyclinics show that nursing staff could outnumber doctors by up to three to one. The BMA