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Premises Charges

Q: We are three practices in a health centre where we are tenants of the PCT, but we are soon all moving into a new primary care centre. At the moment, the practices each pay a nominal health centre charge and annual rates. I queried an increase in rent for one practice some years ago and was informed that the district valuer (DV) set the health centre rent. The PCT also stated that the charges included water, furniture, fittings, heating and lighting. The charges for our area in the new centre are considerably higher than what we pay at present. The rates and lease rent are 100 per cent reimbursable but for utilities we have to pay 60 per cent. Can you advise?

A: In your old health centre, the PCT should have been charging you a rent as agreed with the DV and then reimbursing the same amount.

The PCT should have been looking after the external and structural repair and decoration, and each practice, its own internal repair and decoration.

The rates should also have been reimbursed in full but, in the older style health centres, PCTs were under no obligation to contribute towards practices' costs of utilities, internal service charges, and so forth.

The administration of rent, service charges and utility costs within older health centres was often a little lax.

I know of many practices that paid little or no rent and also ended up, at least in part, getting contributions towards service and utility charges.

When moving to a new purpose-built centre that complies with the PCT's strategic services development plan, a new rent would have been determined by the DV and again, this would be paid by yourselves to the PCT but then reimbursed again.

In a similar fashion, the PCT or landlord should bear responsibility of the structure and external elements together with external decoration, and the practices, their share of the cost of utilities, internal repair and internal decoration. There may also be an internal service charge for attending to common areas.

To encourage GPs to move to these new centres, the NHS (GMS Premises Costs) Directions 2004 expanded on the previous premises funding flexibilities and allowed PCTs, where appropriate, to offer financial assistance towards the practices' payments of running costs (utility costs, cost of internal repair, cost of ground maintenance and also financial assistance towards service charges).

Full details are included in paragraphs 46 and 47 of the directions, where paragraph 47 (b) limits the level of PCT reimbursement to 40 per cent of those costs.

Reimbursement of the above services and running costs is a highly contentious matter because in many PCT areas, such payments are not made at all.

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