Doctors have expressed concern over plans for new health centres which combine GP and dental services with cafes, nurseries and leisure facilities.

Dr Laurence Leaver

Under plans published today, Oxford City Primary Care Trust (PCT) and private investors will plough millions of pounds into a scheme for health centres to share sites with commercial developments, NHS facilities and other services.

Blueprints for the 20-year programme were revealed in the Oxford Mail in August, but today's plans pinpoint development sites.

Areas with the highest health needs will be targeted first, including rebuilding East Oxford Health Centre in Manzil Way, off Cowley Road, and building centres in Dunnock Way, Blackbird Leys, and at the Radcliffe Infirmary, Oxford.

The project, part of the Government Local Improvement Finance Trust (Lift) initiative, is similar to the controversial Private Finance Initiative to fund new hospitals.

With private partners, the PCT will form a company to build, own and lease the health centres, housing GP practices, community nursing teams and community mental health services.

It is anticipated that private developers will concentrate on commercially valuable land, such as Walton Street, where the Radcliffe Infirmary is based.

The PCT is planning to buy three acres of the RI site when services are moved to the John Radcliffe and Churchill hospitals, in Headington, by 2007.

They will be replaced by a £15m centre, housing GPs from Jericho, an outpatient service, X-ray unit, social care, and possible leisure and community facilities set up by Oxford City Council.

Doctors said they feared their practices would lose their identity if they were housed within large mixed developments.

Dr Laurence Leaver practises at Jericho Health Centre where there is one full-time nurse for every 10 doctors, compared with a national average of one nurse for every two-to-three doctors.

He said: "The PCT wants a big, high-profile project to attract interest from developers but, although we would like the local community to have better services, we want to maintain our identity as a health centre, rather than as a group of GPs who share a building with lots of other users.

"We haven't been consulted on these other facilities.

"The university would be quite happy to help fund a health centre, but PCT managers have staked their career on making this work.

"We would have no control over the building and we could be no better off than now."

As well as doctors and nurses, the £11m redevelopment at East Oxford Health Centre would include a local dental clinic, a city out-of-hours service, a cafe and pharmacy.

Dr Helen Groom, a doctor at the centre, said: "This is much-needed investment as we need more staff, but don't have enough space for them.

"The fear is that we will end up in a huge inappropriate shopping mall-style building that people don't want to go into.

"It's important that people feel the practice has retained its identity so people feel that they are still getting a personal service."

Blackbird Leys' £4m centre will have advice and counselling services and opportunities for other facilities, such as a children's nursery.

PCT chief executive Andrea Young said: "Over the next few years we plan to transform health facilities for the people of Oxford.

"We already have excellent GPs and community-based primary care services, but primary care teams often have to work from expensive, cramped and inadequate facilities which limit their ability to expand the services they offer.

"This initiative offers us the opportunity to develop plans which would be beyond most small NHS organisations."

In the second stage of the Lift project, the PCT plans to develop more centres in Rose Hill, Littlemore, Temple Cowley, Wood Farm and north Oxford, by 2010.

The new health facilities in Rose Hill and Littlemore could be run in conjunction with Sure Start, an organisation educating families with young children, which already has projects in the area.

The PCT is currently searching for suitable private partners for the scheme.