Cllr Chris Whitehouse is Chair of the LIFT Council, an Isle of Wight Councillor, and Chairman of The Whitehouse Consultancy.
Whoever is in Government after May 7, it’s clear that public sector capital projects will still require private sector funding through public-private partnerships.
Such partnerships have delivered not only capital funding over the last decade; but also private sector expertise. The only real debate is about which partnerships work best.
In health, PFI schemes are often associated with white elephant hospitals, draining NHS Trusts of vital resources. Whilst that has happened on occasion, there are many examples where public-private partnerships have had a significant impact on the quality of our health infrastructure.
As Chairman of The LIFT Council for the last ten years, I must declare an interest, but the LIFT model is a great example of how government can harness the power of the private sector to make our health infrastructure fit for the 21st Century. Conservative PPCs in England should be engaging with it locally.
The Local Improvement Finance Trust (LIFT) initiative is a Government-endorsed finance scheme first introduced by Labour but built up enthusiastically by the Coalition and its health and Treasury ministers. It’s based on long term joint ventures at national and local level to improve investment in primary and community facilities.
If you haven’t heard of it, that’s probably because it has quietly and uncontroversially been getting on doing the job, delivering the new buildings that were so desperately needed.
More than £2.3 billion of funding has been injected into GP premises and other community facilities. LIFT Companies (LIFT Cos) are the investment and delivery vehicles that have driven this transformation at the local level.
Because they are smaller in nature and less headline grabbing than large-scale infrastructure projects their impact has often been under the radar. They are also an enduring 25 year partnership between the public and private sectors.
Over 500 GP practices have been accommodated in new, modern, purpose built premises through the scheme. It has driven up standards and provided additional capacity, often in deprived areas.
In the past, urban regeneration has often overlooked the practicalities of how community services can be brought together. Through the LIFT model the co-location of services means that communities can access not only primary care services, but also a wider range of services that might include social services, job centre, library, sports centre, housing office, a crèche, post office or local shops all in the same LIFT Co buildings.
This joined up approach makes sense and is why when George Osborne announced in the Autumn Statement that he would invest £1bn over four years in modernising GP premises, he added the important caveat that other community services should be incorporated into the same sites. LIFT is the model he had in mind.
The need to update Britain’s crumbling primary care infrastructure is clear. A recent report by the London Health Commission identified a third of GP practices in the capital are still in need of modernisation, at a cost of £1.5bn. When we add the growing demand for primary care services it is evident that more GP premises need to be delivered and at a faster rate.
Since the release of Simon Steven’s broadly acclaimed Five Year Forward View the NHS has been undergoing a quiet revolution. The new models of care that are currently being introduced will result in a greater focus on treatment in the community and will see GPs leading the way in delivering an expanded range of services in their practices, such as chemotherapy and minor operations.
Providing more services and treating more patients in the community has the broad consensus of those within the health service and the main political parties – and it will boost GP incomes.
But, the only way NHS England can deliver these community-based models is if they have the appropriate buildings that can facilitate them. In short, we need to rapidly expand the primary care estate.
While the deficit remains at historic levels, it would be counter-intuitive to expect the Government to bear the debt burden of unleashing a new wave of infrastructure investment alone. But, if harnessed in the right way, on the right terms, public-private partnerships give us access to expertise and much needed private sector investment.
The success of schemes such as LIFT shows what can be achieved through public-private partnerships.
If we want modern, fit for-purpose health infrastructure, delivered in a timeframe that meets the ambitions of the Five Year Forward View, then to ignore the clear benefits of private sector collaboration would be damagingly shortsighted.
Every Conservative PPC in England (because sadly it is an England only scheme) should check which new health facilities on their patch were built with LIFT funding under the Coalition and sing its praises.
Those who want new facilities for their local communities after the election should identify what is needed, now, and make visible representations to Ministers identifying that need and pointing to LIFT as a potential solution.