GO-IT-ALONE family doctors who control their own budgets have underspent on treatment for their patients by more than £1 million, it has been revealed.

And one GP fundholding practice in East Lancashire made a staggering saving of £283,000 during 1995/96.

The shock figures are disclosed in East Lancashire Health Authority's final accounts for last year.

They show that the 15 GP fundholders in the district made total savings of £1,021 million. None of the practices overspent on their budgets, but three underspent by six-figure sums.

Two of the fundholders are having talks with the health authority to work out how the cash saved should be used.

The biggest underspend was by an East Lancashire practice which saved more than 12 per cent (£283,000) of its budget.

The number of fundholders, who have greater freedom to choose where their patients should be treated by managing their own purse strings, increased from 15 to 46 at the start of April covering 60 per cent of the East Lancashire population (300,000 people).

A top-level East Lancashire Health Authority report said the level of underspend had thrown down a major challenge to the health authority, GPs and local NHS trusts.

The report said it was vital that resources were "deployed and managed" and the reasons for the underspend were understood.

Last month the Audit Commission strongly criticised the concept of fundholding, claiming doctors were failing to balance their books because of big savings on their budgets. But health chiefs and GPs have maintained that savings will be spent on patient care over the next couple of years.

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