THE health minister, Lord Howe, has rejected suggestions that the National Health Service is facing a crisis in some areas, arguing that it is in robust financial health.

It does not appear to be a view shared by the all-party Commons public accounts committee of MPs, which yesterday expressed serious concerns about the forthcoming overhaul of the health service.

Without properly joined up working, there will be more financial instability, with the risk of a deepening debt crisis, the committee has warned.

The concerns surround the replacement of primary care trusts with a larger number of GP-led clinical commissioning groups, which will have greater responsibility for health spending.

The Government is aiming for greater decentralisation, and more local flexibility, but there are loud alarm bells ringing within the public accounts committee about the impact such fragmentation will have on the long-term planning of services.

We have no doubt that efficiencies can be made in the current system, with areas of duplication avoided, and funds focused on areas of greatest local need.

But the noises being made by the public accounts committee are disturbing in that they point to a lack of a clear strategy at the heart of the NHS changes.

And they are particularly worrying so soon after the North Yorkshire and York PCT aired its fears over a £24m deficit which could reach as high as £60m by March unless drastic cuts are made immediately.

In North Yorkshire at least, NHS finances are a long way from being robust.