Select Committee on Public Accounts Minutes of Evidence

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 country.

  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 useful.


  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"[7] and an "effective and flexible procurement mechanism"[8].

  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[9]:

    —  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 local circumstances.

    —  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 sectors.


  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 documentation"[10]. 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 process.

  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

8   ibid, p 3. Back

9   ibid, para 1.1 p 9, para 1.10 p 11. Back

10   C&AG's Report, p 2. Back

previous page contents next page

House of Commons home page Parliament home page House of Lords home page search page enquiries index

© Parliamentary copyright 2006
Prepared 4 July 2006