THE SHOCK disclosure today that more than £1million, earmarked for treatment of East Lancashire patients, was not spent last year reveals one of the biggest flaws of the internal market in the NHS.

This is the fundholding system which is designed to benefit patients by their GPs buying the best and quickest treatment for them from the NHS trusts.

Yet though the government is pledged to reform it by making GPs combine to plan local health services instead of competing with each other for patients and cash, as has transpired, the system's shortcomings remain a canker in the NHS.

That must be the case if, in our region alone, vast sums of money meant to buy treatment for sick people ends up as surpluses in more than half the fundholding GP practices which they then may spend on themselves.

This is especially so when NHS hospitals and community services are crying out for resources, facing another winter of bed crises and struggling with lengthening waiting lists. Surely, such surplus money should be automatically ploughed back into NHS central funds and redistributed to front-line patient care and not spent on ancillary items like computers or furniture for the doctors' surgeries.

There has even been one instance of a fundholding practice in another part of the country spending surplus money on a swimming pool.

We are told that the East Lancashire Health Authority is planning to work with individual GP practices to decide how their unspent money can be used "in the common interest."

There should be no debate about what is the common interest.

This cash should be given back for direct use on health care.

It is, after all, public money in the first place.

And that, surely, begs the question of why so many practices were given too much of it last year - when their tendency to underspend was already clear from the surpluses they had built up the previous year.

Converted for the new archive on 14 July 2000. Some images and formatting may have been lost in the conversion.