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GPs could be saddled with ‘hidden’ deficits as PCTs carry over legacy debts

Exclusive: NHS managers have stepped in to ensure GP commissioners will not have to inherit £150m of PCT debts – but more than £50m of debts carried over from last year have yet to be cleared.

The figures, which emerged today in a report published by the Audit Commission, raise fresh questions about ministers' assurance that GP commissioners will not inherit any debt accumulated before April 2011, with the GPC warning this week any ‘hidden' legacy debt should be cleared immediately. 

In December last year Pulse secured a key victory for its A Clean Slate campaign after ministers promised that GPs would not be saddled with longstanding PCT debts when they take over commissioning responsibilities from April 2013, and would only take on any deficits run up since April this year.  

But the Audit Commission report shows that while NHS London intervened to bail out eight PCTs in the capital in April, a further five PCTs across the country began the 2011/12 financial year with legacy debts.

‘We are aware that within London SHA, in excess of £150 million of financial support was provided to eight PCTs… to tackle historic debt,' the report states. ‘Legacy debt is incurred through overspending in previous years. As at 31 March 2011, £54 million of legacy debt remained across five PCTs.'

Pulse has established that the five PCTs which carried over legacy debts into this financial year are NHS Cambridgeshire (£17m), NHS Surrey (£16.7m), NHS Peterborough (£12.8m), NHS Buckinghamshire (£5.3m) and Bexley NHS Care Trust (£1.8m).

The PCTs said they would repay legacy debts prior to handing over commissioning responsibility to GPs, with some anticipating making up the shortfall in the coming year.

Malachy McNally, associate director of finance at NHS Surrey, said: ‘NHS Surrey is currently predicting an end of year surplus for 2011/12 of £1m. As agreed with NHS South East Coast, our financial planning for this year and next will ensure that any remaining legacy debt is repaid ahead of the abolition of PCTs on 31 March 2013.

NHS Buckinghamshire said it would be ‘paying the outstanding amount of its legacy debt in full in the current financial year', while NHS Cambridgeshire and NHS Peterborough said the debt would be cleared ‘by 2012/13'.

The Department of Health also insisted that clinical commissioning groups ‘will not be responsible for PCT legacy debt that arose prior to 2011/12' and said the issue would be resolved ahead of the abolition of PCTs in March 2013.

But Dr Chaand Nagpaul, GPC negotiator, said the DH should move immediately to ensure any debts carried over were cleared.

‘This needs to be addressed now,' he said. ‘There are some areas where legacy debt is likely to be hidden and it is unfair that new clinical commissioning groups could be saddled with a debt not of their own making. This is not the way to encourage GPs to make the most out of commissioning opportunities.'

‘The Government has stated explicitly that clinical commissioners will not be hit with these debts – that has to happen.'

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