One in three PCTs are in deficit, most significantly so. The DoH considers a deficit significant if it exceeds 0.5 per cent of turnover. More than 100 PCTs are in this category, and around one in five of these have deficits above 5 per cent of turnover.
The aggregate PCT deficit is equivalent to almost 1 per cent of their total turnover. The worst offenders are in the East, South and South East regions of England, and in London.
NHS acute trust deficits totalled £560 million, 1.5 per cent of their total turnover. But SHAs underspent by over £524 million, or 12 per cent of turnover. One SHA recorded an underspend in excess of £50 million, and five of 28 recorded underspends worth more than a fifth of turnover.
The overall NHS deficit of £512 million is better than expected, and the DoH welcomed a £100 million reduction over the past six months.
However, the figures have yet to be independently audited. In a joint report, the National Audit Office and the Audit Commission warned that the 2004/5 deficit almost doubled once auditors corrected accounts submitted by NHS trusts.
Steve Bundred, chief executive of the Audit Commission, said: 'In 2004/5 there was evidence of inappropriate adjustments or omissions in more than a fifth of the accounts submitted for audit by NHS bodies.'
Auditors' adjustments raised the total NHS deficit for 2004/5 from £134 million to £251 million.
The report on 2004/5 finances also says that a small number of NHS bodies considered 'deferring payment of key creditors'.
It says this raises concerns that patient services may suffer as trusts attempt to reduce deficits by diverting resources 'away from normal operational and strategic priorities'.
GPC chairman Dr Hamish Meldrum said there was widespread evidence that deficits were hitting patient services: 'We have had reports of services being rationed through referral management schemes.'
But the GPC rejected claims that pay awards for GPs and other healthcare professionals were to blame.
'If deficits were caused by this, they would be evenly spread across the country, but they are patchy,' said Dr Meldrum.
He added pay rises may have contributed but that the underlying causes were more complex.
'Deficits are more likely to have been caused by the way PCTs are funded, and the creation of foundation trusts and independent sector treatment centres,' he said.
- Opinion, page 25
DoH deficit figures
Live links at GPonline.com
TOP 10 PCTS IN TERMS OF HIGHEST DEFICIT
Selby and York 7.9 %
Cheshire West 8.0 %
Hertsmere 9.2 %
West Wiltshire 8.0 %
Hillingdon 12.8 %
Kensington and Chelsea 7.8 %
Chelmsford 11.0 %
Broadland 7.2 %
North Norfolk 10.4 %
Cambridge City 9.8 %
Deficit expressed as percentage of turnover.