Doctors and managers must pay back NHS cash

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Public Policy Editor

The National Health Service is pursuing a former senior manager of the South Birmingham Health Authority who was given an unauthorised pounds 130,000 in bridging finance and payments to offset the negative equity in his home when he took the job.

Another four managers and 13 doctors in the Yorkshire region are also being asked to repay sums advanced to them chiefly to buy out the negative equity in their homes when they changed jobs and moved to health authorities in the region. In all, the NHS made 18 unauthorised relocation payments totalling pounds 579,000 in 1992-93 - decisions which yesterday led Sir John Bourn, the Comptroller and Auditor General to formally qualify the NHS accounts.

The South Birmingham manager has since left the NHS. But Alan Langlands, the NHS chief executive, yesterday made clear the service would pursue the debt and that managers face possible disciplinary action over that payment and the 17 unauthorised payments made by the former Yorkshire NHS region.

The biggest single payment was in South Birmingham, but Yorkshire region provided pounds 100,000 in loans and salary advances that are being paid back and made a further pounds 348,000 in equity payments as part of relocation expenses. On average the Yorkshire doctors and managers face repaying pounds 20,000 each for the equity debts.

Mr Langlands said yesterday that a formal inquiry had been conducted and the health authorities had been told to "pursue recovery of the irregular payments and, where appropriate, take disciplinary action.

"I take these matters extremely seriously," he said, adding that such mistakes must not be repeated.

Department of Health sources said the payments dated back to the earlier days of the NHS reforms when health authorities and other NHS bodies believed they could behave in a more "entrepreneurial" fashion than they do now. Since the payments were made, a new regulatory framework and new codes of conduct and accountability have been introduced.

Sir John said the sums were not large compared to the pounds 20bn health authorities spend, but he took "a serious view" of the issue.

The NHS Executive has also still to resolve 80 severance payments totalling almost pounds 2.7m that were made to staff in termination settlements. In some cases the staff were effectively sacked rather than simply made redundant.

Those payments led Sir John to qualify the accounts last year, but it will be until October before the NHS Executive finally settles the cases with the Treasury - deciding whether to make the payments ex-gratia or pursue recovery. The Treasury has also had to approve, retrospectively, pounds 165m paid to GP fundholders for management costs for which the NHS Executive failed to obtain Parliamentary approval.

Mr Langlands said yesterday "health authorities must not exceed their powers. The public rightly expects the highest standards of public accountability and probity in the NHS. Nothing less will do."

Sir John's report, however, reveals that NHS trusts are performing much better financially than in their first year, with 79 per cent hitting all three of their key financial targets and 92 per cent of them breaking even.

Overall, trusts made a surplus of pounds 186m, but 23 failed to break even, recording deficits ranging from pounds 15,000 to pounds 3.6m. Twenty lost more than pounds 100,000.

9 NHS (England) Summarised Accounts 1993-94; Paper HC710; HMSO.