Capital investment in primary care - The funding and ownership of primary care premises

The authors describe the complexity of the financing arrangements of Primar y care Premises. They explain how the early vision of integrating health an d social services within local health centres failed to be realized, with G P-owned Practice premises remaining as the dominant model. There was a swit ch to private finance when the government loan body (General Practice Finan ce Corporation) was privatized in 1989. Although capital can now be freely raised by the private sector for investment in the National Health Service (NHS), these debts have to be repaid through NHS funds or user charges. The complexity, combined with demographic factors, makes it likely that as GPs opt for the Personal Medical Services (PMS) scheme and a salaried service, the trend towards for-profit corporations owning and buying out GP premise s will accelerate.