Editorial: Premises problem is not just London's

In June, the GPC warned that hundreds of millions of pounds must be invested in GP premises in the next decade for government plans to shift care out of hospitals to succeed.

A month later, GP leaders attempted to break the deadlock over investment in primary care premises at a summit with health minister Lord Howe (GPonline, 8 July).

However, earlier this month, a report by former Labour health minister Lord Ara Darzi called for the 'greatest investment in London's general practice since the NHS was founded in 1948' (GPonline, 15 October).

The report by Lord Darzi, now chairman of the London Health Commission set up by mayor Boris Johnson, says: 'London needs a £1bn programme over the next five years to rebuild or refurbish every GP practice in the capital.'

The Health and Social Care Act 2012 may have so paralysed NHS management (not that it takes much to do so) that GP premises developments have been, in effect, frozen (GP, 18 July) but, at last, it would appear, someone is listening.

However, GP practices are likely to be expected to open longer in return for the investment - although perhaps not all 8am-8pm seven days a week, as some GPs clearly fear (lead letter, page 32).

Londonwide LMCs chief executive Dr Michelle Drage is right to ask where the £1bn is coming from and whether the focus is on new premises, rather than upgrading existing practices.

But this problem is not unique to London.

Two-fifths of practices in England are inadequate, according to a BMA survey (GP, 18 July). Almost 70% of GPs said their facilities were too small to deliver extra services, and more than half have had no investment or refurbishment for a decade.

The GPC estimates that if £1bn is needed for London, the figure should be £5bn for England and more for the UK.

Congratulations London, if you have found the answer to the GP premises problem, but GPs in the capital need far more detail about the conditions attached to the extra funding. Why fuel criticism that England is London-centric and why not expand any premises solution to the rest of the UK?

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