27 July 2001
In its report, Inpatient and outpatient waiting in the NHS, published on July 26, the NAO said that of 558 consultants contacted, almost 300 said they would treat patients in a different order from their clinical priority to help meet NHS waiting list targets.
Around 20% of those surveyed said they 'frequently' did so in 1999/2000.
'Clearly there would be pressure from senior managers and clinicians, but some consultants give less urgent patients priority to reach targets,' deputy auditor general Martin Pfleger told Public Finance. 'They have told us they are concerned about that and also that it can have a negative impact on the patient.'
Among the examples the NAO highlights of priority-shifting to meet the government targets are a routine vasectomy performed at the expense of urgent bladder tumour surgery and a non-urgent sinus patient given treatment before more serious cases.
The report also warns that the government's intention to reduce waiting times for operations to six months in 2005 as part of the NHS Plan could only exacerbate the problem faced by the 20,000 consultants working in the NHS.
David Davis MP, chair of the Public Accounts Committee, said he was 'extremely concerned' by the NAO's findings. 'There must be no backsliding from the fundamental principle that those in greatest need are treated first,' he said.
The NAO did find inpatient and outpatient waiting lists had reduced over the past two years – but notes that at March 31 this year, 246,000 people had been waiting more than six months for hospital admission. Of these, 42,000 had been on the list for more than 12 months, up from 30,000 in March 1997.
The NAO recommends that health trusts should be made to monitor the total time patients wait, explore the reasons for significant regional variations, and validate waiting lists at least every six months to eliminate inconsistencies and uncertainties over patient categories and priorities.
PFjul2001
