Your article on the Lift primary healthcare programme raised some interesting points about how effective the scheme has been since its inception and certainly merits further analysis (26 January, page 38).

When Lift began, the primary care estate was quite literally crumbling in many parts of the country and extra investment through private capital was required to stand any chance of bringing the necessary improvements to health services. The programme initially focused on deprived areas where it has overcome decades of neglect and helped to address significant problems for the recruitment and retention of GPs.

What is interesting is that Lift has evolved through that time and is now a procurement option for the community hospitals programme, which the Department of Health announced in the autumn of 2006. And now other government departments are taking an interest in it, with a view to replicating it elsewhere.

As the department itself points out, one Lift facility a week opened throughout 2006 and is continuing to do so into 2007.

The average procurement time for wave one was 21 months, much less than the three years or more than is the norm for other PFI-type projects.

There is though, of course, more still to do. The number of projects coming out of the strategic partnering boards is not as quick as many would like, although the reconfiguration of PCTs has no doubt contributed to this slowdown. Engagement with local authorities could be improved to really deliver on the regeneration agenda, although many examples of good practice do already exist.

Lift was, and still is, a highly ambitious attempt to drive up quality in the primary care estate, an estate for which an overhaul and clear strategy was long overdue. It needs to evolve further as it moves ahead, but with advanced primary care facilities at the heart of the government’s plan to shift care out from the acute estate, Lift will be here for many years to come – delivering value for money in public procurement and a public sector building stock fit for the 21st century.

Chris Whitehouse, chair, LIFT LOBI

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