PFI project ‘lifting finance’ from primary care

A new scheme to buy and build primary care premises might be taking funds from other primary care needs, an influential committee of MPs has said.

The public accounts committee has expressed concerns over the Local Improvement Finance Trusts (Lift) initiative, which was designed to provide £1 billion worth of investment, from both the private and public sector, to build primary care premises.

“Whether [Lift] represents value for money no one yet knows,” said Edward Leigh, chairman of the public accounts committee.

“What we really need to know is whether the expected benefits to patients justify the cost of using Lift to provide the new facilities.”

The Conservative MP said it was “essential” the Department of Health and Partnerships for Health speed up their development of an evaluation system for the Lift programme.

Traditionally, primary care premises have come from a variety of sources – including private ownership by GPs, private sector leases and central NHS provision.

This means that the majority of such premises are not purpose built.

In 2000 the Department of Health launched the Lift scheme, a public-private partnership, to deal with the long-standing problems caused by under investment in premises.

However, the public accounts committee today expressed concerns that premises built under this scheme are more expensive than those acquired in more traditional ways – and that this could be diverting money away from more pressing healthcare needs.

“Providing new, purpose built buildings for GP and other primary care services is obviously going to be more expensive than carrying on with older premises,” Mr Leigh said.

“The danger is that procurement under Lift might lead to funds being diverted away from other primary care needs.

“Business cases for Lift projects prepared by primary care trusts must clearly compare the cost of Lift to that of other procurement methods.

“They must make transparent what the Lift route would mean for spending on other primary care facilities and services.”

The total capital value of the buildings in the first 42 schemes was £711 million, with an average Lift building costing around £5 million.

Some 51 local Lift projects had been established across England by December 2005.