Sixty seconds on . . . Department of Health accounts

BMJ 2016; 354 doi: (Published 14 September 2016) Cite this as: BMJ 2016;354:i4978
  1. Anne Gulland
  1. London

They’re the gold standard for good accounting, obviously?

Not exactly. The House of Commons Public Accounts Committee has described the Department of Health’s most recent set as “rotten.”1

Why, aren’t they accurate?

Well, they are slightly out. They contain details of an unexpected £417m (€500m; $550m) windfall in national insurance contributions that the health department had failed to declare to Her Majesty’s Treasury.2

I suppose they have to pay that windfall back?

HM Treasury is not asking for it, probably because the mistake, which the health department has described as an “an administrative error,” turned the department’s potential £207m deficit into a £210m surplus.2 Don’t expect that they will be so generous if there are any such mistakes in Jo Public’s tax return.

So, what was the accountants’ excuse?

Brexit, apparently. Chris Wormald, permanent secretary at the health department, said, “There was quite a lot going on at that period, and it was seven days after the formation of a new cabinet.”

At least they filed them promptly?

Depends how you look at it. They were laid before parliament five months in advance of the statutory deadline, to coincide with the publication of a plan by the NHS on how it was going to reset finances.

That’s good, isn’t it?

Not exactly. They were actually laid before parliament on the last day before MPs rose for the summer recess in July—seven days after they had been signed off by the comptroller and auditor general. The chair of the Public Accounts Committee, Meg Hillier, described this as “sailing too close to the wind” and said it was “an underhand attempt” to cover up the poor state of the health department’s finances.2

Could do better, then?

Absolutely. Hillier described the accounts as having “wafer-thin margins, a series of short term fixes that are not sustainable, and piecemeal measures.” She added, “I am seeking assurances that this won’t happen again.”

And what about next year?

The NHS has an extra £3.8bn to spend this year. Whether the health department will be able to keep track of what it has done with it at the end of the year is anyone’s guess.


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