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Independents' Day

Silent sell-off: how private companies exploit cheap GP rents

Government freeze on rent reimbursements for GP premises is squeezing partners out and promoting the sell-off of NHS property, warns Dr Chris Peach

We have one of the best new premises in South London, but in the past 14 years we have received virtually no increase in rental income.

This is despite rocketing property and rental prices around us and I am advised that there is now a decree from central Government to local negotiators not to agree any uplifts in rental for premises; in other words, the NHS is artificially keeping GP premises values at low levels.

We were lucky enough to be able to fund our own premises improvements, but those GP practices that engaged in LIFT, or other third party developer schemes, now face the real dilemma that under the new rules their landlords will have the right to charge a rent which exceeds that which the NHS will reimburse the practices.

That means that once again NHS GPs will be paying for the privilege of going to work. At some point this will be challenged through the courts and the NHS may well be required to reimburse any backlog of underpayments, but in the meantime corporate groups are buying up GP surgeries at a rate of knots as they have been made very affordable by artificially depressing their value.

There will come a time soon when the organisations busy buying up these properties suddenly decide that they are sufficiently ahead of the market to pull out all the stops and challenge the system. They will be in a position to fend off new challenges and achieve an enormous increase in their asset values by challenging the rental returns and seeing a legitimate increase in both their rental returns and in the asset value of their property portfolio. We are not far away from that time; a ticking time bomb is about ready to explode.

More worrying still is the fact that the massive changes in our NHS have increasingly relied upon primary care expanding the extent and range of services offered to their local community of registered patients. With major failings in secondary care being reported daily there is yet ever increasing pressure on primary care to come to the rescue.

The infrastructure needs of primary care have therefore continued to increase enormously. With large swathes of practices now being owned by a few key corporate players and with these corporates now showing interest in operating practices as well as owning practices one might (perhaps somewhat cynically) question whether we are witnessing the silent set-up of widespread takeover of the NHS by the private sector via the primary care route.

Individual practices, perhaps out of necessity have been selling out their own assets to the corporate sector, but is this perhaps a somewhat naïve misunderstanding of the importance of retaining autonomy by keeping ownership of infrastructure within their own partnerships? If we are ever to preserve the true value of independent practice necessary to support the future of the NHS then our autonomy remains the single most important feature.

The alternative is a de-professionalised corporate structure delivering services. Any true professional GP knows only too well that the ‘group think’, protocol-driven, management-controlled service that comes from the corporate sector is destructive to the personal and very individual doctor-patient relationship that underpins professional NHS services especially at primary care level.

Fortunately for our practice and our patients, we own our own premises and will resist the controls of the corporate sector. It would be nice to have a just and reasonable return for our efforts, but we are not dependent on it.

But many other GPs are rapidly approaching a point where there would be a better return from virtually any other use of their property. It is time for a more honest, open, sustainable and sensible approach to setting rents and funding new GP premises.

Dr Chris Peach is a GP in south London 

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Readers' comments (9)

  • Dear Dr Peach....
    you are right.... the government is introducing policies to favour private capitalists and put public money into the hands of their chums at westminster.... as per my references to Prof Field as below:

    He will probably be looking for a job with crapita or another private provider.... all our leaders on the slippery pole are looking to become special 'advisers' with Care UK, BUPA etc. Its all part of the same plan to keep privatising the service, he will join the ranks of the likes of Alan MIlburn (Paid to advise bridge point capital - who bought care UK), Virginia bottomly (BUPA) Lord Warner (Labour -calling for £1/month NHS membership fee for all patients - likely to go straight to private providers- what did he think taxes were for?) Patricia Hewitt (Now employed by Boots -40% of their work NHS, adviser for Cinven - bought 25 hospitals off BUPA)-more than 40 peers stand to make significant fortunes with every block of the NHS being sold off... so you can see where our governments priorities 'lie'..... meanwhile the Tax Payers ALLIANCE - , which sounds neutral but is actually a right wing neoliberal think tank founded by Matthew Elliott and paid for, well rather opaquely, its hard to find out who pays for it, but it is sponsored by the same people sponsoring the Conservative party...will keep calling for tax cuts under the guise of 'efficiency' by blowing out of proportion examples of waste in the NHS (Not the waste which goes in fat profits to the private providers e.g. PFIs) , which will benefit the rich but further run down public service, hence the fed up public will agree to more privatisation to 'improve' the service, hence further enriching the Westminster cartel, meanwhile our useless leaders play the fiddle whilst the NHS burns, when instead the RCGP should have the spine to be calling out all the fraud happening at the top of the system. The press will meanwhile distract the public by blaming those in the public sector for not being productive enough, dole spongers and immigrants when the actual costs of this are insignificant again the billions of tax evasion and fraud by our social elites.... its no wonder people voted for Brexit.... but they need to take aim directly at those involved.....

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  • Spot On MM.

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  • Really informative article. Our notional rent was reduced by nearly 40% at the last review......backdated almost 3 years as the district valuer was so far behind with his rent have suffered a massive clawback of well over a year's rent........where are the BMA / GPC?? Nowhere to be seen 😡

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  • We have been fortunate to have been able to extend our premises in recent years but have just received notional rent review stating no change despite the surgery being 20% bigger. We appealed but to no avail. Obviously heating/electricity bills are higher and maintenance. Very disappointing and leaves me out of pocket.

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  • The great NHS rip off continues......from todays BBC news..... "One leading economist, John Appleby, from the Nuffield Trust, told the BBC that the NHS alone was repaying private firms about £2bn a year for PFI schemes and the cost of interest payments for completed projects was likely to total £56bn by 2048."

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  • National Hopeless Service

    Who would want to be a partner ever.

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  • Heads they win, tails we lose.

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  • I left General practice (I was a single handed principal) many years ago when the plummet over the cliff started. I kept my surgery and rented it back to the PCT. I received a decent reimbursement and it increased annually by RPI. All was good.
    Then the PCT/NHS England contracted a private contractor to provide the services. My lease was then with them, but they were totally controlled by NHS England who seemed to bully them. My rent was reduced by a massive percentage and ever since, NHS England have squeezed successive contractors so badly that they have both now left, unable to run the surgery well or make a decent profit. The surgery finally closed down yesterday and the patients have been dispersed.
    It seemed calculated by NHS England who were always pushing to close this surgery. It was a modern purpose built surgery in an expanding end of town, with good car parking and no other surgery for miles.
    As for me? I am working as a private doctor in another field and I love it. I am hoping to rent the surgery to a private tenant at a decent commercial rate or may even provide private services from it myself.
    I honestly feel that the government is deliberately sabotaging general practice.

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  • All around us are well funded big practices . We are small and had no grants and no offers for 30 years . No wonder cqc fail small practices

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