Managers and doctors surveyed thought the government's targets were unachievable. Four leading primary care players give their views.
Harry Hyman, managing director of Primary Health Properties (pictured), says: 'Anything the government can do to streamline the process is very welcome, ' although what looks 'good on paper may be harder to structure than they envisage. '
He describes the targets as 'extremely optimistic'. 'We are keen to invest in this sector, but are finding the slow rate of progress enormously frustrating.
LIFT is one of our frustrations. We read about the creation of something called LIFT, but nobody knows anything about it. '
But the biggest struggle is 'getting adequate returns for our investment', because of the financial discrepancy between the rent set by the district valuer and what it costs to build. 'The system in its current format is not working. '
Barry Panton, chair of financiers and developers Prime, says: 'The physical development, funding, planning and finding sites is not a problem. What could slow things down is strategic clarity and people knowing what they are trying to achieve. '
He claims he has no problem with the current system. 'You can see obstacles if you want to, but if you analyse them they are there to safeguard the public purse. ' But he warns against 'putting too short a timescale on things or you could end up with white elephants'.
Tony Stanton, chair of the British Medical Association practice premises sub-committee, says: 'The problem is essentially a simple one:
namely the lack of money for carrying out the building programme needed. The government has cash-limited the money available for improvement for one reason - and that is to limit the amount of money spent. That could be changed if there was the political will. ' He cannot see how£175m of public money 'will mysteriously become£1bn. . . It is a case of now you see it, now you do not'.
Chris Town, chief executive of North Peterborough PCT, has recently helped develop a one-stop health centre using private finance, although 'it wasn't planned as such'.
He says of the government's plans: 'I think they're ambitious, but I think they're right. ' To achieve 500 one-stop centres would require 'around five per HA, That is less than one for every PCT. It ought to be achievable. ' He doesn't see a problem with the current regulatory system. 'You build the maximum you can under the Red Book and then add other funding streams. ' For example, 'you can charge a premium rent for added-value services such as pharmacies because of the merits of being on a health centre site. The danger is that the money will be put into bringing existing premises up to current standards, when what is needed is to cut and run and start up again, ' he says. 'I am not sure that organisations are geared up to take up the strategic perspective that is needed', although he thinks PCTs are well placed to drive this 'by offering good local leadership and bringing together the different funding streams'.