A GPs' leader is trying to fight controversial contracts which he claims lead to Doncaster doctors paying for 'toilet rolls instead of patient care'.
Representatives of the borough's GPs are in talks to try to re-negotiate the terms of the deals on the buildings which is claimed leaves them struggling to pay costs attached to the deals in public-private partnership buildings building under a programme called LIFT - Local Improvement Finance Trust.
They say the problem is rooted in clauses in the contracts which bind doctors to using specific providers for services such as cleaners, which they say are too expensive.
LIFT was a public/private sector partnership formed to create new community buildings to deliver community health care and other services.
Dr Dean Eggitt, the secretary of the Doncaster Local Medical Committee, which represents its GP members at local, regional and national levels on all matters relating to the provision of healthcare, has been in talks with the company which owns and rents the surgeries to try to change the deal.
Dr Eggitt said: "I'm trying to re-negotiate contracts for the Public Finance Initiative. These NHS premises leases are not in favour of the provider. The NHS re-imburses costs like rent, but not costs like cleaners gardening services and costs like toilet rolls.
"These costs are astronomical and it is these costs that are putting GPs out of business.
"GP practices don't want to pay the bills because they don't understand them. Most of the practices have refused to sign a new lease and refused to pay them."
The costs are items which doctors say are tied to the contracts they sign with the Community Health Partnerships which own the sites. Doctors believe they are higher than they could get elsewhere.
"This is one of the things that is killing GP practices off," said Dr Eggitt
"Money is going on toilet rolls instead of patient care."
He added the Denaby Practice at Church View, which closed last Autumn after the doctor who ran it handed back the contract, was one of those which had been a LIFT practice where the doctors had struggled with finances.
There are 12 Doncaster practices in premises let by Community Health Partnerships.
A CHP spokesperson said lease agreements had not been changed and there had been no change in 'soft costs' like cleaning services since 2015/16
They said: “We are working with the Local Medical Committee and the GP practices in Doncaster to assign existing leases to new GP Partners due to changes in practice ownership since the original leases were signed. We have not changed the lease agreements, but the practices need to complete a legal process to ensure the continued provision of safe and compliant patient services from our healthcare buildings.
“We fully understand that GPs would want to scrutinise costs. Rental charges are linked to the Retail Price Index, annual increases are in line with this. We are addressing queries in relation to the cost of soft services such as cleaning and grounds maintenance including garden areas, the contract for which was put in place by the then Primary Care Trust. We can confirm there has been no increase in these costs since 2015/16 and we are working hard to improve the value and effectiveness of these services for our tenants.
“Community Health Partnerships is a company wholly owned by the Department of Health. We have created modern, healthy spaces for better patient care through public private partnerships called LIFT, or Local Improvement Finance Trusts. We have delivered a property portfolio worth £2.5 billion for the NHS, by investing £100 million of public money.”
Meanwhile, a second medical practice has asked to close its list to new patients - but had the request turned down.
Dr Eggert said the Thorne Moor practice, in Thornem has asked to close because they did not physically have enough space to take on more patients at their site on Fieldside in the village, and in Moorends.
A spokesperson for NHS Doncaster Clinical Commissioning Group said: “We received an application from Thorne Moor Medical Practice to close their patient list to new patients because of accommodation problems at their two surgeries, which are at the Vermuyden Centre, Thorne and Orchard centre, Moorends.
“The CCG’s Primary Care Commissioning Committee considered the request in July but decided to decline on the basis that other options for utilising the available space and facilities within the two buildings should be explored first. We are working with the practice to see how this can be achieved.”
The Dunsville Practice, at Dunsville Medical Centre, became the first in South Yorkshire to close its list to new patients earlier this year after it saw its number of doctors reduce from three to two, and then one of its GPs going on long term sickness.