'Bunions put ahead of hip ops'

Doctors tell of patients being treated ahead of more serious cases to meet targets

As a National Audit Office report shows doctors feel they are being pressurised to put meeting waiting list targets ahead of clinical need, BBC News Online details the stories of some medics on the front line.

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Dr Gordon McLellan, orthopaedic surgeon from Oldchurch Hospital, Essex

Dr McLellan told BBC Radio 4's Today programme patients with bunions could be treated ahead of those with hip replacements.

He added patients waiting for hip replacements will sometimes be waiting in the ward for treatment, but see less serious cases whisked through to the operating theatre before them.

I'm very pleased that the NAO has confirmed what consultants and patients have known for a very long time

Dr Gordon McLellan,
orthopeadic surgeon

Dr McLellan added: "I'm very pleased that the NAO has confirmed what consultants and patients have known for a very long time."

He said that if hospital trusts failed to meet the 18 month target for treating patients, they were fined, leaving managers to make a stark choice.

"Do they treat patients coming up to the 18 month target, or do they allocate extra resources to cancer patients."

He said the NHS failed people. "For a quarter of a million people every year, its not a service.

"Some are waiting up to 48 weeks for a scan."

He told how cancer patients would wait two weeks for a clinic appointment, but then may have to wait weeks for a diagnostic scan before they could be put on the list for surgery.

Dr Joe Cahill, a consultant surgeon at Kingston Hospital

Dr Cahill told the BBC: "I think we've all come under pressure with the intense emphasis to admit an 18-month waiter rather than a clinically more urgent case.

"But the actual instances are few and far between - and the urgent cases have only had to wait a day or two more."

Joe Cahill: says there has been an 'obsession' with waiting lists

He welcomed the government's shift in emphasis onto waiting times, rather than slashing the numbers on waiting lists.

Dr Cahill said there would always be a need to balance the treatment of patients who had been waiting a long time with those who had more serious conditions.

He said day case surgery would be a way of getting some patients the treatment they needed quickly.

But he added there was vast variation around the country in how much of that kind of surgery was carried out.