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Cash-strapped PCTs are turning down an increasing number of bids from GPs for urgent premises improvements.
Accountants and developers report as few as one application in 10 from GPs is being approved by some trusts.
In a recent round of applications in Gloucestershire, just two out of 20 projects were given funding.
The situation was mirrored in Hampshire where only three out of 14 bids from GPs submitted to the strategic health authority by PCTs were approved.
It is understood at least eight other bids were not even submitted by trusts, as they were not considered a priority.
Dr Philip Hopwood said his practice in Alton, Hampshire, was in a 'rundown, 30-year-old building' which needed to be knocked down and replaced. 'However, we were told we were not a priority,' Dr Hopwood said.
'Developers are falling over themselves to carry out the work but that can't happen if we cannot get the rent reimbursement we need from the PCT. If we are not a priority now I just can't see us ever being a priority or ever getting this work done.'
GPs in Trent, Surrey and Sussex were also reported to be having problems.
David Robson, managing director of PMP Health Developments, said the Government was hindering its own policy of getting GPs to take on more secondary care work by not putting in more cash.
Ministers bowed to GP pressure by investing an extra £108 million in premises in July last year, but only £42 million is available for 2004/5. The money is also only for capital investment and does not cover cost-rent reimbursement.
Mr Robson said: 'It seems strange that the Government is seeking to take services out of secondary care and into primary care but is not providing the funding to enable practices to expand to cope with this.'
GPC practice premises subcommittee member Dr Peter Fellows said the lack of money was creating a 'serious problem' for many GPs.
By Joe Lepper