This is the rather dramatic start of the HSJ article yesterday:

At a time of a huge financial squeeze being put on hospitals and when treatments of all sorts are being cut or delayed (or “rationed”), it turns out that the Department of Health – the unit in charge of the NHS – has a huge surplus that it is returning to the Treasury.

Andy Burnham MP has written to Jeremy Hunt MP as follows.

Dear Jeremy

NHS Budget underspend

Figures published today by the NHS Information Centre show that in December 2012 there were 4,887 fewer nurses working in the NHS than in May 2010. This followed the Care Quality Commission Care Update, published earlier this month, which warned that 11% of hospital services inspected were failing to meet the standard on adequate staffing levels.

You can therefore imagine my surprise when reading figures published in the detail of the Budget document yesterday that show the Department of Health is expected to underspend against its 2012-13 expenditure limit by £2.2bn.

Furthermore, the table on page 70 of the Budget document appears to show that none of this has been carried forward to be used in subsequent financial years as part of the Budget Exchange programme.

At a time when the NHS is facing its biggest financial challenge, when almost 5,000 nursing posts have been lost since the general election, and when one in ten hospitals are understaffed, I find it staggering that £2.2bn of the NHS budget is to be returned to the Treasury.

It would be helpful if you could therefore answer a number of important questions.

1.    Were you aware of the £2.2bn underspend before yesterday and did you authorise the decision not make any use of the Budget Exchange programme?  Or were you overruled by the Treasury?

2.    If so, when did you make your decision?

3.    Can you confirm that this means the Department’s underspend for 2012-13 would be 2%, higher than the 1.5% figure that your Department says is consistent with “prudent financial management”?

4.    Do you accept the recent findings of the Care Quality Commission that one in ten hospitals are failing to meet the CQC standard on adequate staffing levels? Did you consider this when making your decision?

5.    Why did you not make use of this underspend to prevent job losses and ensure all hospitals have adequate staffing levels?

6.    Yesterday, a Department of Health spokeswoman told the Health Service Journal that the NHS underspend would “still be available for NHS organisations to ensure high quality, sustainable health services are delivered to patients now and in the future”. Can you confirm that this will not be the case, as none of the £2.2bn underspend has been carried forward for future use?

I look forward to your response.

Best wishes

Rt Hon Andy Burnham

The plot thickens…

efficiency savings