Moving into a polyclinic will more than double an average practice's premises costs, a GP investigation has revealed.
The policy could cost the NHS an extra quarter of a billion pounds every year.
A suburban four-GP practice currently receives rental reimbursement of around £100,000 a year. But premises expert John Hearle, chairman of surveyors Aitchinson Raffety, says comparisons with health centres built under NHS LIFT suggest that practices' annual premises costs could rise to £250,000 if relocated to a polyclinic.
He credits this to higher administrative costs, facilities management fees, and the investors' need for profit.
This means that NHS Lon-don's plan to create 150 polyclinics would cost an extra £140 million a year. A further polyclinic in every PCT in England would mean another £114 mil- lion in annual premises costs.
'I don't think there's any doubt that polyclinics will be more expensive,' Mr Hearle added.
Who pays these extra costs will likely be a matter for negotiation between practices and PCTs, but they will be funded from the overall NHS budget, cutting funds for patient care.
GPC negotiator Dr Stewart Drage said practices could not be forced to foot the bill: 'Our message to GPs is that, unless somebody else is paying, stick to your guns and stay put. There's nothing to force practices to move into polyclinics.'
Justin Cumberlege, a lawyer with Carter Lemon Camerons, suggested that practices could actually benefit from negotiating on expenses.
'If you own your premises you're responsible for the equipment,' he said. 'But if you move into a polyclinic, you could end up in modern premises with all new equipment reimbursed by the PCT.'
Mr Hearle's figures raise doubts about Lord Darzi's claim that polyclinics will save London £1.5 billion over the next decade.
A recent report on polyclinics from the influential King's Fund think tank warned that there was no evidence that poly- clinics would save money.
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