Published: 31/01/2002, Volume II2, No. 5790 Page 4

The NHS across England could be facing an end-of-year overspend of up to£150m, which would make the normal brokerage arrangements to cover local deficits impossible, despite assurances from health secretary Alan Milburn that this would happen, according to HSJ sources.

Although most regional offices refused to provide details of the expected year-end position, figures made available nationally earlier this month showed serious overspends in three regions. The figures, which recorded the position at the end of November, showed that South East, South West and East region had projected overspends of around£30m each. This position had changed by last week, when it was revealed that South East region alone had a projected£60m overspend.

Break-even was being projected by London, North West and Northern and Yorkshire regions, Trent was projecting£3-5m overspend, and West Midlands up to£2m overspend. The overall position was forecast to be a total£100-150m overspent.

Although Mr Milburn made clear last week that the South East regional shortfall would be resolved by brokerage arrangements, such arrangements depend on surpluses being available elsewhere. It is also understood the position could worsen by an additional 1-1.5 per cent when the latest drug prescribing figures come through.

With two months left until the next financial year, guidance is also still awaited on whether health authority accumulated deficits will be carried over to primary care trusts, as health authorities are abolished and strategic health authorities set up. A Department of Health working group considering Shifting the Balance of Power is looking at this issue.

Although a decision is awaited in England, Welsh health minister Jane Hutt last week announced that the combined loans from the Welsh Assembly to all Welsh trusts and HAs, a total of£41.2m, had been written off.

West Surrey HA finance director Peter Reeves said that although he would welcome the debt being written off, there would be problems as the money had been loaned from other health bodies.

He said that in the case of HAs 'the brokerage is got by an HA somewhere else' and that to write off the loans 'would need an infusion of money'.