FURIOUS doctors at a busy Bolton health centre are refusing to pay an increase in service charges because they say they are so cramped it is a health risk. GPs from Great Lever Health Centre will withhold about £1,600 a year in costs towards heating, lighting, caretaker and general maintenance until improvements are made. And they say other Bolton health centres have been improved for "vote catching" reasons.

The protest is aimed at the Bolton Community Healthcare Trust, which owns the building.

The GPs are angry because the building which was intended to accommodate two practices, now squeezes in four.

The four doctors at the centre - on Rupert Street, Great Lever - say nothing has been done to alleviate not only the lack of space in the reception area, but problems with holes in the ceiling, a faulty heating system, and stains where the roof leaks.

Dr Robert Mitchell said: "Apart from everything else, the reception area is not healthy."

The doctors are refusing to pay the 50pc increase in the service charge. They are also turning to the local community for support.

The Community Healthcare Trust says investigations have already started into the possibility of extending the centre, but no decision has yet been taken. Dr Robert Mitchell outlined the grievances in a letter to Mr Patrick Wallace, chief executive of the Bolton Community Care Trust.

In it he says: "We are all here to provide adequate health care to our patients. We feel the present arrangements at Great Lever do not give this opportunity.

"The cramped accommodation gives rise to health risk to the staff - possibly in breach of the health and safety regulations - poor morale and hence poor service to patients. Action is needed now."

The surgery was built just over 10 years ago, but in that time, the doctors claim, not only has there been an increase in practices and patients, but in administrative workload.

Dr Mitchell told the BEN: "With the increased service for patients come complaints procedures and extended records.

"There is far more administration and additional space is needed to accommodate computerisation. "There is no confidentiality where reception staff work, and conversations on the telephone are impossible if the computer is on. Screens are desperately needed."

Dr Mitchell, added: "We cannot help but note the sudden appearance of funds to provide a new centre in the town - Lever Chambers - and the extensive refurbishment on a centre in the area of Bromley Cross where the space was already greater than ours.

"The centre at Dunscar now has more space for two practices serving fewer patients than the centre at Great Lever.

"Great Lever is an area of marked deprivation. It is in this area that funds should be spent as this population is in the greatest health need.

"I ask is there some political implication here? Bromley Cross is in a marginal area so votes could be bought. Great Lever is Labour so no need for 'buying votes'."

Mr Wallace replied: "Community Healthcare Bolton NHS Trust charges doctors accommodated in health centres a service charge. This is required to meet the costs of heating, lighting, cleaning and portering services used by GPs. There has been a need to increase the service charge due to real cost pressures. This is the first change to the service charge since 1991/92. The service charge remains as low as possible at approximately £26 a week. "Community Healthcare Bolton has discussed in detail with Doctors Mitchell, Sabrine, Newgrosh and Loomba the problems they have, associated with limited space available at Great Lever Health Centre.

"Work has been undertaken by Community Healthcare to obtain information about the structural and financial implications of providing extended accommodation. This information is being considered and no decision has yet been made regarding the possible extension.

"Any decision to invest in a capital development at the Centre must, in order to ensure value for money, be viewed in the wider and longer term context of the overall pattern of service delivery in Bolton and other healthcare priorities.

"Community Healthcare Bolton fully supports Dr Mitchell's statement that 'The improvements must be seen to have a major improvement on healthcare'.

"Community Healthcare Bolton will seek agreement from Wigan and Bolton Health Authority before undertaking any major capital development."

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