BMA threatens legal action over 'astronomical' GP service charge hikes

BMA leaders have threatened legal action over 'astronomical' service charges that have left GP practices in NHS-owned premises facing debts of almost £180m.

GPC chair Dr Richard Vautrey (Photo: BMA)
GPC chair Dr Richard Vautrey (Photo: BMA)

The threat of legal action came as the National Audit Office (NAO) published a report into NHS Property Services (NHSPS) - the government-owned company set up in April 2013 to run NHS estates.

The report suggests that around 1,250 GP practices in England are in premises owned by NHSPS - and that these tenants owe a combined £173m in 'outstanding debts'. It calls for tougher powers for NHSPS to force tenants including GPs to pay charges and sign lease agreements - warning that 'too many NHS organisations and GPs seem to regard paying for their premises as optional'.

However, BMA leaders accused NHSPS of 'acting unlawfully', warning that practices have faced unjustifiable hikes in service charges, in some cases for non-existent services or for services practices had already paid their local council for, without agreement.

Service charges

The BMA said one practice was charged for a lift that did not exist, and others have warned that charges are levied with no clear breakdown of what they are for. The BMA says it has 'repeatedly' asked for clarification on service charges demanded from practices in NHS-owned premises, and has now threatened legal action if its questions are not answered urgently.

GPs have previously warned that steep rises in fees had left some practices on the brink of going out of business - and the BMA has repeated that many practices fear they simply cannot afford the increased costs.

BMA GP committee chair Dr Richard Vautrey will tell the association's annual representative meeting (ARM) on Wednesday that: 'For years now some practices have faced astronomical rises in service charges, some seeing theirs more than double, often for services they have not asked for and do not receive.

'This is unacceptable and cannot be allowed to continue. And so I can tell you today that the BMA has sent a letter of claim to NHS Property Services and if they do not give us an acceptable response we intend to take them to court, and we intend to win.'

Responding to the NAO report, Dr Vautrey added: 'Problems with practice premises and the financial pressures that go alongside owning or leasing surgery buildings are constant frustrations for hardworking GPs, and have an important negative impact on GP recruitment and retention.

Practices at risk

'In recent years, GPs leasing buildings from NHS Property Services have seen their service and maintenance fees rise astronomically with no agreement and no proper explanation. It is only right then, that GPs do not pay these fees that could risk the very future of their practices and the ability to provide care for patients.'

The GPC chair said it was 'simply not the case' that GPs saw paying for premises as optional as the NAO report claimed. He said: 'Practices want to pay a fair and appropriate rent but this needs to be reimbursed by CCGs.

'A lack of funding in recent years means commissioners cannot keep up with sky-rocketing commercial rents demanded by NHSPS, and they’ve simply passed the problem and the cost to family doctors. This is unacceptable at a time when practices are already under huge financial strain.'

An NHSPS spokesperson said the organisation was working with the BMA and that a recent review of specific cases had concluded its charges were 'broadly correct' - and that a meeting had been set up with the BMA and NHS England to 'discuss the underlying central issue of affordability'.

NHSPS chair Ian Ellis said the report showed how NHSPS has 'used its property expertise to invest £447m upgrading, maintaining and developing new NHS facilities, and in addition selling 410 surplus properties and raising £347m by March 2019'. He added: 'All capital receipts are reinvested into the NHS estate and land and building release has enabled the development of 5,931 new homes to date.'

He highlighted comments in the NAO report on 'legacy issues' inherited by NHSPS, including 'the widespread absence of formal rental and service agreements'.

Mr Ellis said: 'NHSPS, as a responsible property owner and service provider, is committed to working constructively with the DHSC, NHS England and other NHS partners, to support the recommendations of the NAO investigation, including to develop a joint plan to ensure all tenants will agree tenancy details and charges by 31 March 2020 to create a properly regulated, transparent and optimised estate for the benefit of our customers and their patients, now and in the future.'

The total amount owed to NHSPS by its near 7,000 tenants is £576m, and more than £100m more has been written off, according to the NAO report.

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