When the NHS started in 1948, doctors already had practices, usually some room(s) attached to the house. As this space was used for NHS patients, rental was charged to the NHS. This system continues for the great majority of practices to this day, although now the buildings are usually exclusively used for work.
As the doctors owned and managed the buildings practices were not standardised, the quality of the premises depended much on whether the doctor was willing or able to spend on the building. There was little financial incentive for doctors to invest in premises, despite a scheme known as cost-rent, most of the time the money for improvements had to be paid by doctors, without generating additional income, certainly not in the short term. There were some experimental health centres provided by the health authorities in the 1960's and 1970's but often little investment was made in the upkeep.
In the last few years however, the provision of buildings by health authorities has made a revival, only they are usually owned by private companies and leased to the doctors, backed up by guaranteed payments from the health authorities (your taxes). These 'public private partnerships' have ceased nearly as soon as they started when the cost of these arrangements became public.
On this page we show how much surgeries receive (expressed as pounds per patient per year) for their building. It may surprise you that there is no standard tariff, and therefore common minimum building standard cannot be expected. We had waited for years for this information and it has been published by the HSCIC (careful, large file) in 2015.
How can you expect or demand that buildings are of equal standard if one practice has been given more money than another? Why are practices not given the same budget for buildings that meet the same standards in the first place?