It looks like a financial report. It reads like a press release. The Government's NHS Expenditure Plans 2000-01 is an odd hybrid.

Financial specialists say it reads like a fairytale. It says that NHS trusts reported a deficit for 1998-1999 of£36m - not a figure that many finance experts would recognise.

NHS efficiency is referred to in glowing terms - without saying anything about whether targets have actually been achieved. Management costs have reduced, and£292m that would otherwise have gone on bureaucracy has been freed for patient care - but there is no word of where this money comes from, what percentage it represents of total management costs or what the consequences have been.

Healthcare Financial Management Association chair Barry Elliott says: 'It doesn't describe the world we live in.'

He welcomes the extra expenditure promised in the Budget but says it will allow the NHS deficit only to stand still. 'The overall indebtedness of the NHS is now about£900m and it's that balance sheet's effect on liquidity that is one of the main concerns for us professionally, ' says Mr Elliott.

'Health authorities and trusts are really struggling to come up with financial plans for the coming year that will balance and enable them to meet all the government targets.'

Tom Jones, healthcare spokesman for the Association of Chartered Certified Accountants, also welcomes the extra spending but adds: 'There are massive cost pressures or deficits - or whatever you like to call them - in the pipeline.Some people put it between£400m and£1bn.

'Fiddling about with 10 per cent of management costs is not going to plug any gaps.'

The Government's Expenditure Plans - 2000-01.

www.doh.gov.uk/dohreport/report2000/dr2000.html