Conclusion 5

There is not a level playing field for all NHS tenants in terms of the rent paid and compulsion to pay it. About 18% of GP surgeries in England are owned by NHS Property Services. The rest are either commercially owned or owner-occupied. We are concerned that one GP practice can pay a full rent on its commercial premises, while another GP practice down the road occupying broadly similar premises can get away with not paying its rent on time or at all. In addition, tenants were not always fully charged for rent and services before NHS Property Services took on ownership. Initially, the Department agreed that tenants would only be charged 60% of their total charges with the remaining 40% being charged to commissioners. These arrangements have largely been withdrawn over time, but current levels of subsidy are not known. Some tenants have cited affordability as an issue for their unwillingness to pay bills, and this is sometimes linked to the withdrawal of subsidies. The Department accepts that the current system can lead to unfairness and that it needs to work with commissioners on a case-by-case basis to ensure fairness. Recommendation: The Department needs to move towards a more equitable model of charges, with transparency about any subsidies that are received, and ensure that tenants and commissioners are funded at an equitable level. 8 NHS Property Services 1 Performance to date