Memorandum submitted by LIFT LOBI
LIFT LOBI is the Liaison Organisation for Business
Investors in LIFT schemes; the representative body for private
sector partners. The membership comprises 13 organisations; over
90% of the private equity investors in LIFT ventures around the
LIFT LOBI acts as a forum for debate and decision-making
for members on all issues relating to LIFT and represents the
interests and consensus opinion of its members.
We are grateful for this opportunity to provide
Committee Members with our considered response to the NAO Report
and hope that Members will find the information contained here
NAO REPORT "INNOVATION
NHS: LOCAL IMPROVEMENT
The National Audit Office Report on LIFT examines
whether the scheme is able to support improved health care services
while providing value for money. It finds that LIFT is an "attractive
way of securing improvements in primary and social care"
and an "effective and flexible procurement mechanism".
LOBI members welcome the positive findings of
the NAO Report and the constructive recommendations contained
therein. We believe that the benefits of the LIFT system are wide-ranging
and it is gratifying to see these benefits identified by the NAO:
Provision of new purpose-built GP
premises suitable for modern primary care.
Integrated care: co-location of healthcare
professionals helps to forge links between primary and social
care with benefits for staff and patients.
Flexible leases and share options
help to resolve GP recruitment and retention problems.
Local strategic direction and partnerships
with community stakeholders ensures development is tailored to
Advanced primary care centres and
chronic disease clinics reduce pressure on secondary care.
Rapid delivery of necessary primary
care development where it is needed most.
Significant developments have taken place within
the LIFT market since the publication of the NAO Report in May
2005. LIFT stakeholders have since identified the need for the
development of a credible Value for Money (VFM) evaluation system
which could be applied to all LIFT ventures.
LIFTCo's are contractually obliged to provide
evidence of the value for money of potential schemes in comparison
to both LIFT and non-LIFT developments. We recognise the Office
for Government Commerce definition of Value for Money, and its
assertion that simple benchmarking should not be seen as a substitute
for a comprehensive VFM test.
We support the opinion of the NAO: "whole
life costs over the length of the partnership are inevitably uncertain.
The cheapest option may not, therefore, be the option which offers
best value for money".
A Value for Money system will ensure that potential
individual LIFT ventures are accurately judged using long-term
criteria and local communities receive full value for money.
LOBI has engaged collectively over the past
three months in conceiving, developing and building such a comprehensive
value for money system with Ernst and Young and with the support
of the NAO and Partnerships for Health. The system will be used
for the assessment of every past and future LIFT scheme. It carries
the support and endorsement of all LOBI members. We continue to
work to finalise and publicise this important system and hope
that it can be used as a future model for procurement in other
Our experience supports the view of the NAO
in that PCTs do indeed welcome "a long-term approach under
local strategic direction together with national support and standardised
It is for this reason that we have closely monitored recent communications
from the Department of Health regarding changes to the future
role and configuration of PCTs, and how these changes may impact
upon LIFT ventures.
LOBI notes the rapidity of recent Department
of Health moves to alter the role of PCTs, from providers to commissioners
of primary care. While we understand the desire to move forward
with the modernisation of the health service, we encourage the
Department to continue to consult widely on changes to the nature
of primary and social care. Given the extremely positive Report
from the NAO any reconfigurations to primary health care should
continue to include LIFT as an essential element of the system.
The LIFT scheme has been tried and tested. It
has been proven to work flexibly and effectively within a wide
range of health frameworks to deliver on tangible health improvement
goals. It strikes a vital balance between public and private sector
involvement in an approach which offers breadth and focus. Reliable
long term investment in healthcare facilities is ensured and can
be channelled to areas of high deprivation which might otherwise
be neglected under different procurement methods.
Dozens of communities have already been given
a vital boost by LIFT ventures. It is crucial that they continue
to be supported in this manner and that the scheme is expanded
in order that more areas may benefit.
The Government White Paper on out-of-hospital
care, due to be published at the end of 2005, will form the basis
of future developments in health and community care. LIFT LOBI
is engaging fully with the current pre-publication consultation
LIFT LOBI members look forward to the publication
of the White Paper and to working with all partners to guarantee
the future of modern, patient-led health care in England with
LIFT at the heart of this vision.
7 C&AG's Report, p 2. Back
ibid, p 3. Back
ibid, para 1.1 p 9, para 1.10 p 11. Back
C&AG's Report, p 2. Back