The £1.7bn surplus made by the NHS in England in 2007-08 has come under fire from parliament's spending watchdog.
Edward Leigh, chairman of the public accounts committee, said last night that at least part of the money should have been spent on patients who were denied access to life-saving drugs or were provided with low-quality care.
It was reasonable for the health service to build up a contingency reserve, but the 2007-08 surplus was twice what NHS chiefs had planned, he added.
Leigh, the Tory MP for Gainsborough, was responding to a joint study by the National Audit Office and Audit Commission, which concluded that the surplus "reflected good use of resources rather than a failure to deliver healthcare".
The auditors said the NHS had made good progress in meeting national healthcare targets, including reducing waiting times and hospital acquired infections.
Steve Bundred, chief executive of the Audit Commission, said: "The surplus is equivalent to about one week's funding for the whole NHS. The organisations in the NHS are performing better financially and this surplus has created an element of certainty for financial planning that has not existed in recent years. This is especially reassuring given current financial pressures throughout the economy."
Tim Burr, head of the National Audit Office, said: "The surplus was generated through good financial management: NHS bodies delivered more cost savings than expected while still delivering against targets and improving the quality of healthcare. But better forecasting of the outcome could enable resources to be deployed more flexibly in-year."
Leigh, whose committee supervises the NAO, was more critical. He said: "The surplus represents a large amount of money that could have been spent on NHS patients and wasn't. While national targets were met, there are still examples of local organisations which are falling below standard, both medical and financial, and which might have benefited from additional cash.
"The Department of Health does not plan for the NHS to spend the surplus until at least 2009-2010. It is good to build in contingency, but it is a lot of contingency when, in certain parts of the country, patients are still being denied access to drugs and receiving low quality care."
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