GPC holds NHS England to ransom over premises payments
The GPC has said it will not approve NHS England’s request for a standardised contract for GP-rented properties unless it reverses its position on the removal of trade waste and reimbursement for stamp land duty tax.
The BMA is currently in negotiation with NHS England over ‘premises directions’ - the rules dictating what payments local area teams are obliged to make to all GP practices - after NHS managers stopped making many of the discretionary payments that had previously been provided by PCTs.
The GPC’s lead negotiator on premises, Dr Peter Holden, has told Pulse that he will not agree to NHS England’s request for a standardised contract until NHS England relents on the payments.
NHS England was tasked with negotiating a standardised lease agreement for the estimated 10% of GPs leasing centrally-owned premises last year to replace the myriad of different contracts locally drawn up by PCTs before the NHS Property Services handover.
But the GPC has told NHS England that it must reinstate payments for trade waste removal - as highlighted by Pulse earlier this week - alongside a number of other demands before agreement on the standardised contract is reached.
The GPC’s other demands include:
- guaranteeing reimbursements related to stamp duty land tax, the tax payable when signing premises lease arrangements for a term of eight years or longer;
- adding a ‘flexibility clause’ which would allow GPs to call on the area team for financial support if they thought their arrangements around reimbursements had become unfit for purpose, which was negotiated for this year’s directions but subsequently omitted from the final directions that became effective last April;
- and clarifying who is responsible for paying to obtain a premises valuation from an independent surveyor as part of leasehold rent reviews, for which some GPs have also had to pick up the bill.
Dr Holden said: ‘There are a range of things that [NHS England] wants to have signed off [by the GPC] and I have said I will not sign anything off until I get the 2014 premises directions that satisfy me, and there are four outstanding items there.’
‘Basically you can say that until I get into the 2014 regulations the things that were missing from 2013’s, I have refused to agree or support any of those standardised documents. I have told the company [NHS Property Services] that I will tell the profession to sign nothing until we get what we want, and the reason I am going to do that is because at the end of the day, they need us more than we need them. Do they really want the Daily Mail headlines, of “GPs thrown out of premises they’ve been in for 20 years because they wouldn’t sign documents with which they were not happy?”.’
He added: ‘For once we have to get tough, and I have got very tough.’
A spokesperson for NHS Property Services said: ‘It is a matter for NHS England and the DH, who are leading on the negotiations around premises directions.The matter of standardised leases will follow on from their settlement.’
An NHS England spokesperson said: ‘NHS England has been holding negotiations with the GPC and these are ongoing. Any comment prior to the conclusion of these negotiations would be inappropriate.’
The news comes as NHS Property Services has set out on a consultation to restructure the business, after admitting its current service is not effective. In the consultation document, published at the end of January, the company admitted that it currently has ‘an inconsistent and fragmented service delivery model’ and a ‘lack of specialist technical knowledge’ in some areas, while customer feedback had demonstrated that the ‘service delivery can be unresponsive and/or ineffective’.
Created last April to manage the health services’ £3bn property portfolio, the company has struggled to collect debts and was last summer forced to negotiate a £100m loan from the Department of Health. Board minutes from November last year showed that it had collected only 23% of rent owed from tenants. Currently, the company is also attempting to improve its financial position by selling off land for residential developments, as ordered by the Government.
A spokesperson for the company said the restructuring will save between £7m and £10m on permanent and agency staff annually and ‘improve how the company meets the needs of tenants, customers and NHS patients, as well as deliver greater efficiency and value for money’.