This paper presents a study of the Local Improvement Finance Trusts (LIFTs) that are being used to procure new health care premises throughout the UK. The data were obtained from two of the first phases of the schemes, comprising of seven individual health centres with a total capital cost of approximately £26 million. The research was qualitative in nature and assessed the complete process of procurement from bidding and negotiation through to completion. The analysis highlighted difficulties in demonstrating value for money and concludes that the bidding process can be an unequal struggle between large consortia and inexperienced clients that may result in a wasted opportunity to obtain the optimum design and price. In terms of governance, the procurement process was extended to later phases before full evaluations of the schemes had been undertaken. Findings further show the additional cost of premises procured in the above manner and the ability of the scheme to meet the government’s objectives in the later phases.