GPs 'must' pay to expand premises

GPs will have to finance the expansion of their own premises if they want to provide services usually provided in secondary care and do not currently have the room, according to health minister Lord Warner.

Last month's White Paper, 'Our Health, Our Care, Our Say' outlined plans to shift 5 per cent of NHS services to primary care. This will be partly achieved by practices commissioning themselves to provide services through practice-based commissioning.

The DoH has committed to funding 50 community hospitals to enable the shift in services, and it hopes to have 100 LIFT schemes underway in England by the end of 2006.

However, these LIFT schemes are not necessary for GPs and there will be no additional money for GPs wishing to expand their own practices.

Health minister Lord Warner expects GPs to pay for expansion of their own premises.

He cited a Sheffield practice where the GPs financed improvements to premises themselves, and now 'act as a landlord' of their polyclinic.

They sublet rooms to the PCT for non-practice clinics.

The minister implied that GPs would be able to ensure that their profits went up as a consequence of their improved premises.

'If you can combine the volume of activity to achieve a wide range of support services, there is nothing to stop you,' he said.

The DoH has also committed to 20 'polyclinic' demonstration sites as a result of the White Paper, not necessarily funded through LIFT.

Lord Warner said the polyclinics would have some practices based in them, but that it would not be necessary to be part of such a clinic to refer to it.

Dr Eric Rose, chairman of the GPC's practice finance subcommittee, said Lord Warner was 'mistaken if he thinks practices can borrow money for development'.

'How can you finance a building if you cannot guarantee the rent?' he asked.

'Many practices I know would go ahead with work on premises if they could guarantee rent payments, but this matter lies with PCTs, and the money coming down to SHAs is not enough.'

He felt the premises obstacle was not big enough to stop practice-based commissioning, but was a 'block to polyclinics if that's what the government wants'.

Dr John Poyser, professional executive committee chairman at Sheffield West PCT, which set up the Sheffield polyclinic as part of a private finance initiative, said the scheme could offer increased flexibility to GPs than LIFT.

However, Dr Poyser said that before building could commence, the PCT had to agree to underwrite the scheme and all parties signed an 'agreement to lease' so that income was assured.

Dr Poyser said: 'There has been a necessary leap of faith in the scheme from the PCT, but we've yet to see if it will land with the jam-side up or down.'

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