Case study: The doctor

Dr Fay Wilson and her four partners run a GP service from a temporary building for which the planning permission ran out a year ago. The structure is tacked on to a 1960s surgery that is too small, not sound-proofed and has malfunctioning drains.

Dr Fay Wilson and her four partners run a GP service from a temporary building for which the planning permission ran out a year ago. The structure is tacked on to a 1960s surgery that is too small, not sound-proofed and has malfunctioning drains.

"It would be very good in Somalia but this is 21st-century Europe," she says. "We don't have enough clinical space or waiting room space and it is boiling in summer and freezing in winter. It is amazing we manage to do what we do in it."

The practice, in Highgate, Birmingham, has 7,500 patients and serves one of the most deprived areas of the city. Dr Wilson and her colleagues have been lobbying the health authority for a new building for years, without success.

"We have given up on the health service," she says. "We have gone to a private finance company and asked them if they can build us a building and rent it back to us. If the finance company can't make it stack up it won't happen."

Under the NHS national plan, up to 3,000 GPs' premises will be refurbished or replaced by 2004 under a new equity stake company called NHS Lift, involving a public-private partnership.

Dr Wilson's existing building broke health and safety regulations but staff continued to work because they were dedicated, she said. "We can't carry on as we are. We will have to dismantle things if we don't get a new building," she said. "We want to the Government to send us a million or two. This is one of the most deprived populations in the country and they deserve it."

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