Four out of ten GP surgeries in Brighton and Hove are "substandard", health bosses have admitted.

Brighton and Hove City Primary Care Trust (PCT) said 23 out of the 55 surgeries in the city were not fit for purpose in the 21st Century, while 14 of them needed to be replaced altogether.

Many of the surgeries are crammed into converted houses.

Some are too cramped to protect the confidentiality of patients because of the proximity of receptions to waiting areas.

Others do not have sufficient access or facilities to meet the needs of disabled people.

The dire state of GP surgeries in Brighton and Hove was revealed by a survey of health trusts conducted by Pulse, a magazine for GPs.

It found at least one in seven GP surgery buildings in the UK - more than 1,000 in total - were unfit for purpose.

They included seven surgeries in Arun, Adur and Worthing, seven in Crawley and five in Sussex Downs and Weald.

Pulse editor Jo Haynes said the state of GPs' premises was jeopardising Government plans to move more services out of hospitals into primary care and give GPs more control over NHS spending.

She said: "GPs want to take on more work from hospitals and to provide more services for patients from their surgeries. But they are being prevented from doing so because the Government refuses to invest the comparatively small amount of money to enable primary care organisations to fund new premises."

Dr Peter Holden, of the British Medical Association's general practitioners' committee, said the results of the survey showed the Department of Health was spending "peanuts" on premises.

A spokeswoman for Brighton and Hove City PCT said: "We are aware that at least 25 per cent of our 55 surgery premises need to be replaced.

"Many are converted houses or shops with limited disabled access and insufficient space for modern primary care."

The spokeswoman said the development of purpose-built surgeries with disabled access and high quality consulting rooms and waiting areas was under way in Preston Road, Old Steine and Mile Oak.

Others in Whitehawk and Patcham were in the final planning stages.

She said: "It is a challenge in Brighton and Hove to find sufficient space in the right parts of the city to build new health centres but we are working closely with the city council planners to identify appropriate sites."