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More than 650 practices are working from buildings deem-ed 'below minimum standards' because of the drought in premises funding.

Government figures show the recent drive to upgrade premises stalled last year, with some areas registering an increase in numbers of substandard surgeries.

The number of premises 'below minimum standard' fell by 6 per cent, from 700 to 657 in 2004. This compares with a drop of more than 200 practices in the previous year.

In the south-east of England the number of surgeries below a minimum standard more than doubled. The Yorkshire and Humberside region also saw a 23 per cent rise.

Dr Peter Swinyard, chair of the GPC premises subcommittee and a GP in Swindon, said there was an 'enormous logjam' of GPs wanting to move but unable to do so.

He added that the South-East was suffering most because development costs were higher. 'There's a higher end value so there's a higher recurrent cost in terms of the rents.'

Dr Swinyard added: 'I'm delighted that some have been upgraded but it really is a matter of concern that there are so many practices suffering.'

Dr Gary Calver, secretary of Kent LMC, said many doctors wanted to expand and take on more staff but were already working in overcrowded premises. 'It's difficult until the Government decides practice premises are an area they want to spend money on.'

Dr John Givans, secretary of Bradford and Airedale LMC, said even premises developed 10 years ago were now too small for GPs' needs.

He added: 'You are lucky if you can get one major rebuild in your area. GPs are getting very frustrated.'

Dr Alex Bobak said his practice in south-west London had to bring in a private developer 18 months ago to fund a move from substandard shop-front premises, which did not comply with disability discrimination legislation.

But he said the new practice was already getting cramped.

The Department of Health said it was 'delivering one of the largest and most sustained programmes of modernisation of primary care premises in the history of the NHS'.

By Rob Finch

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