Q21 Kitty Ussher: Thank you very much; that is encouraging. We obviously have a huge shortage of dentists in my part of the world-I am sure I am not alone-and my constituents are desperate to see as many dental seats in there as possible available to the public on the NHS. Are there any guidelines as far as you are concerned to ensure that happens?
Mr Coates: I am not aware of any formal guidelines on the number of dental facilities to provide within LIFT. If you wanted a note, I would have to come back to you with that. I am sorry.2
Q22 Kitty Ussher: It would be useful to know whether there are.
Mr Johns: There are actually dentists taking up occupation in buildings already. We have about a dozen dentists and in fact in Birmingham we have a dentistry training facility which has been developed as part of the initial LIFT scheme there.
Q23 Kitty Ussher: It is obviously a great opportunity. There has been concern amongst local independent pharmacies that the way that the contracts are being given for pharmaceutical services inside the new LIFT building effectively crowds out local provision. My understanding of current government policy is that they do wish to support independent pharmacies. That certainly will not happen as a result of the way the contract has been let in my constituency, which is a pity. They have not felt able to bid commercially. Is that something you are seeking to avoid?
Mr Coates: No. There is no guidance of which I am aware where we say that sectors cannot bid for franchises in LIFTCos and there is certainly no central guidance which tries either to target or limit independent involvement in LIFT premises.
Mr Johns: Indeed on the visit last Thursday there were two representatives from local pharmacies who were there, who are operating from the facility we visited in Church Road in East London. What they told us was that the local independent pharmacists had formed a consortium so that they could provide services from the LIFT building. I think that is a model which has been considered in other localities as well.
Q24 Kitty Ussher: Perhaps I could pose the question the other way. We only have one or two local independent pharmacies which are interested and I think that the national players are not interested in forming a consortium with them, so they are completely unable to compete in the absence of guidelines to say that local pharmacies should be looked at sympathetically. Should we not have that?
Mr Coates: Is your question around the money side of it, affordability?
Q25 Kitty Ussher: I presume it is money. I presume that the large pharmacies like Boots and Moss-I do not know the specifics-are able to undercut by virtue of economy of scale.
Mr Coates: My understanding on the pharmacy side in LIFTs is that PCTs can support the rental cost within the development. For example, if they feel that it is essential that there is a pharmacy within the building then they can subsidise the rental paid by the independent contractors.
Q26 Kitty Ussher: So this is something we can take up with the PCTs.
Mr Coates: Yes.
Q27 Kitty Ussher: There is also concern that some GPs who are currently based in deprived areas, which is seen as a good thing, will be sucked into this momentum to relocate into the centre of town. Is that something you are seeking to avoid?
Mr Coates: To avoid?
Q28 Kitty Ussher: Yes.
Mr Coates: The location of health services within any economy is clearly down to the local PCTs and their Strategic Service Development Plan (SSDP). All LIFT tries to do is to provide a framework within which we can provide assets and services flexibly to the local economy. There is no central guidance of which I am aware which tries to do what you are suggesting in terms of bringing people in from the suburbs.
Q29 Kitty Ussher: Do you accept that if the facilities offered in a LIFT centre are of excellent quality then GPs may be more likely to want to move there and thereby provide a less good service to people out in deprived communities?
Mr Coates: That is a risk, but with the additional funding going into the NHS over the next two or three years it is a case of rolling out improvement as and when we can. All we can do is target the initial developments on the areas of greatest need and then cascade those out to other areas over time. I am not aware of any policy which you are suggesting in terms of trying to squeeze anybody out.
Q30 Ms Johnson: I should like to start by talking about the role of the local authority and the important role that I think they should have within this structure. I was interested to see in the Report that there is only one local authority which is actually a shareholder and I think that is Barnsley. Do you have any comments about the role that local authorities could or should be playing and are not at the moment?
Mr Coates: May I ask Brian to answer the question about local authorities' involvement in LIFT now as opposed to when the Report was written?
Mr Johns: Things have moved on since the Report was undertaken by the NAO. I am aware of four localities which have local authority shareholding already. They are Newcastle, Barnsley, Doncaster and Nottingham. There may be one or two others of which I am not aware but at least those four do have shareholdings. I fully agree with your question. We think it is absolutely vital to get the joined up working between primary care trusts and local authorities. Referring back to the Burnley scheme, that is actually an integrated scheme which is both health provision and also a sports centre for the local population. The strategic partnering board encourages that joint strategic planning between PCTs and local authorities.
Mr Coates: You do not have to be a shareholder to invest in local authority accommodation. It does not necessarily follow that you have to be an investor to get in.
_____________________________________________________________________________
2 Ev 30