5. The National Audit Office Report compared LIFT to both traditional public capital investment and third party development (paragraphs 1.6-1.9). The reasons why the final Report did not quantify the cost of the alternatives and compare them to the cost of LIFT are expanded on below.
6. There was a lack of information on suitable comparators procured using alternative mechanisms. The National Audit Office considered comparing the cost of LIFT to third party developments and noted the different financing and contract structures in such developments, together with different whole life cost profiles. Moreover, analysis of individual leases including rent review clauses and the extent of further charges such as utility and insurance services would have been necessary. The National Audit Office met with several third party developers who were unwilling to share detailed data.
7. The National Audit Office asked each PCT and LIFTCo to provide examples of suitable primary care developments by way of comparison. It found that public finance in the form of central funding was rarely available and usually only for small scale refurbishment and redevelopment. At present improvement grants of up to £100,000 are available so long as there is a commitment that the development will remain in the NHS for 10 years.
8. The CIPHP briefing paper refers to funding under the London Improvement Zone (LIZ) which was available until 1999. It cites the example of the Fairfield Grove Health Centre, Greenwich which was completed in 1996 for a contract value of £1.5 million. Fairfield Health Centre offers integrated primary health care facilities for general medical practice, community services and other primary care practitioners. Its size and the fact that it was completed nearly 10 years ago suggest that it is not a good comparator for LIFT.
9. In the light of the interest shown by the Committee of Public Accounts in such comparisons the National Audit Office approached the PCTs involved in the case studies in its report to try again to find meaningful comparators. Information on a comparable third party development-the Lyng Centre for Health and Social Care is provided in the supplementary memorandum to the Committee. The PCTs could not find any comparable centrally funded developments.