The Secretary of State for Health (Dr. John Reid): The national health service LIFT programme is a means of improving primary care facilities to address a legacy of under-investment. It is making good progress. Contracts have been signed for six schemes and work has begun on the ground. By the end of 2003, 268 new one-stop primary care centres had been developed and almost 2,000 GP premises had been refurbished or replaced. Most facilities will be provided through traditional procurement routes and such developments will continue.
Tom Brake : I thank the Secretary of State for that response. For several years, GPs at the Shotfield health centre in Wallington have been pressing to renovate the facilities and the project appears to be about to take off. Will the right hon. Gentleman confirm that GPs will not be forced to follow a LIFT route and that there are concerns among health professionals about the long-term costs of LIFT projects? Does he accept that, provided that the GPs' proposal represents best value and is what patients want, it should be allowed to proceed?
Dr. Reid: As someone whose party supports decentralisation of decision making, the hon. Gentleman understands that important decisions about the provision of local health care services should be taken locally by the primary care trust, obviously working with GPs. It is right that what happens at Shotfield should be decided locally.
On costing such schemes, the hon. Gentleman could look to the well-advanced LIFT scheme in his constituency. I believe that the south-west London LIFT scheme includes a project at Green Wrythe Lane clinic. The planned new one-stop primary care centre will be four times the size of the existing scheme and exhibit benefits, including the services that it will provide to some 6,000 patients, thereby enabling much better integration of health and social services. Such examples show how effective the refurbishments can be, but the decisions must ultimately be made locally. That is why 75 per cent. of our money is allocated in a decentralised fashion to primary care trusts.
James Purnell: There was genuine enthusiasm at a recent meeting that the Tameside and Glossop primary care trust held about our local plans to improve GP services. Does my right hon. Friend agree that those plans offer an opportunity to examine the prevention of illness, keep people out of acute services and ensure that we can bring all the professionals together to work in one place and offer a one-stop-shop service?
Dr. Reid: Yes, I agree with my hon. Friend. The NHS plan, which we published some years ago, promised new and improved premises. Since its publication, six new GP premises in the Tameside and Glossop area have been replaced or refurbished. The local primary care trust there intends to develop extended primary care services in three locations across Tameside and Glossop with a total capital value of approximately £15 million. It is currently considering the different methods of doing that, including NHS LIFT. My hon. Friend, like many people, has benefited from the £1.5 billion that we are investing through LIFT schemes to refurbish or replace GPs' or family doctors' premises throughout England.
Mrs. Marion Roe (Broxbourne) (Con): Will the Secretary of State tell the House whether he is worried that only two local improvement finance trust programmes have reached financial closure? What action are the Government taking to persuade, convince and reassure local banks that LIFT schemes are not risky investments?
Dr. Reid: I am not sure about the premise of the hon. Lady's question, if I heard her correctly. I can tell her that, by the end of 2003, 268 new one-stop primary care centres had been developed and almost 2,000 GP premises had been refurbished or replaced. Most facilities will be provided through traditional procurement routes, but the LIFT programme involves more than £1.5 billion of capital investment. There are far more than two schemes currently under way, but if the hon. Lady has areas of special difficulty in her constituency and she writes to me, I shall be only too happy to respond.
Mr. Ivan Henderson (Harwich) (Lab): I welcome the LIFT projects in my constituency, which include a new community hospital in Harwich and a new medical centre in Holland-on-Sea. Will my right hon. Friend keep a close eye on the primary care trusts so that when they introduce such valuable initiatives, they take note,
Dr. Reid: I can confirm that, as my hon. Friend suggests, the proper way of proceeding involves maximum consultation and taking decisions locally. As he points out, a considerable amount of money£1.5 billionis being invested in this scheme alone. In addition, a further £195 million has been spent up front to help local projects to do the necessary preparatory work, such as buying sites, undertaking surveys and demolishing old buildings. If we add that £195 million to the approximate figure of £1.5 billion, we reach an amount not unadjacent to £2 billion, which is precisely the amount that would be taken away in any proposed patient passport scheme, which would subsidise the rich to jump the queue.
Derek Conway (Old Bexley and Sidcup) (Con): On a less partisan note than the Secretary of State has just employed, although both sides of the House support the new one-stop centreshe is right to praise his Department for themmay I ask him to address the question of the type of older property found in my constituency? Will he tell the House whether the scheme applies adequately to facilities for elderly and disabled patients, particularly in older surgery properties?
Dr. Reid: Yes, indeed. I mentioned that by the end of 2003, almost 2,000 existing premises had been refurbished or replaced. In addition, extra money is going in as part of the new contracts for general practitioners. In general terms, we are carrying out the biggest building programme in the history of the national health service. I extend to the hon. Gentleman an unpartisan fact: in the year in which our Government came to office, almost half the premises in the national health service were older than the national health service. That was a disgraceful residue, but I can tell him that by the end of our third term in government, in 2010, almost half of NHS premises will have been built during the Labour Government's three terms.
Mr. Kevin Hughes (Doncaster, North) (Lab): I welcome the fact that three local improvement finance trust schemes are proposed in my constituency, at Askern, Thorne and Moorends, which will greatly improve the front-line delivery of health care services to my constituents. However, can the Secretary of State assure me that the red tape surrounding the LIFT arrangements will not stand in the way of early progress on those three schemes?
Dr. Reid: I can assure my hon. Friend that everything possible will be done to expedite those three schemes. I am not aware of particular reasons why any of them should be delayed, but I will certainly try to ensure that they deliver the improvements in health care in the Doncaster area that are much deserved and needed. Just as the much-needed bridge in Doncaster, which was delivered under a previous Transport Minister, brought great relief to Doncaster's transport, so will these new premises bring additional relief in health care.
Alistair Burt (North-East Bedfordshire) (Con): Involving third parties with the NHS in the provision of health care is obviously a commendable principle. To encourage that still further, will the Secretary of State look again at the impact of VAT on charitable appeals aimed at providing further health care? That can tie up money that could be used for the development of health care in the primary and secondary sectors, as we found recently with the Primrose appeal in Bedford, on which the hon. Member for Bedford (Mr. Hall) and I wrote to the Minister of State, Department of Health, the right hon. Member for Barrow and Furness (Mr. Hutton).
Dr. Reid: The hon. Gentleman makes his point skilfully but, as he knows, reconsidering tax matters is largely, although not exclusively, confined to the ambit of my right hon. Friend the Chancellor of the Exchequer.