There’s never any shortage of demand for healthcare. Rather, the public expects more than the NHS is ever likely to be able to provide.

So it seems odd that hospitals and health trusts in the West Midlands managed to spend £153 million less than they were allocated.

It has led to concern that patients may have been denied treatment which would benefit them – and for which money was available.

Health trusts were encouraged to end the financial year with a surplus, to give them a safety-net for the future.

But in the event, they underspent by twice as much as planned.

It is important to note, however, that the surplus does not appear to have been built up at the expense of treatment.

It is not a result of job cuts or cancelled operations, according to the National Audit Office. And the underspend is at least an improvement on the massive deficits run up by health trusts a few years ago, when NHS finances appeared to be out of control.

The reality is that the NHS is still suffering from the turbulence which caused so many trusts to go into the red.

Earlier this decade, Ministers realised that nobody really knew whether individual health trusts boasted good financial management or not, as those that failed to stay within their budgets were subsidised by those which enjoyed surpluses.

The Government decided to change all this by forcing every trust to open its books and tell the world where it stood financially.

And those that failed to live within their means were ordered to cut back.

As a result, the health service entered a period of dramatic change in which many jobs were lost.

A few finance directors were among the casualties.

And while the worst appears to be over, health budgets are still in a state of flux.

Having made the efficiency savings required of them, some trusts now find they are unable to spend all the money that is allocated to them.

It is clearly true that some patients who have been denied or forced to wait for treatment could have received it if the money had been spent.

But this may be a short-term problem – as the pendulum swings too far the other way following a period in which trusts were in deficit.

NHS managers must ensure that more use is made of all the resources at their disposal in future years.