The NHS is improving but some patients are still missing out, a report from the government's health watchdog says.
Some groups of patients are not getting the best available care
The Healthcare Commission says the NHS has succeeded in cutting waiting times and reducing deaths from cancer and other major diseases in recent years.
But its State of Healthcare Report says there are still wide variations between different areas and groups of people.
"Those most in need may still be getting the worst deal," said the commission's chairman Sir Ian Kennedy.
The commission examined NHS care in hospitals and clinics across England and Wales.
It found that patients now have shorter waits for treatment.
For instance, in March fewer than 50 people in England were waiting longer than nine months for a hospital operation. This compares with 131,000 five years ago.
Similarly, just 18 were waiting longer than four months for a hospital outpatient appointment. This compares to 111,000 18 months ago.
How life expectancy differs
A girl born in Manchester can expect to live to 77.3 years
A girl born in Kensington and Chelsea, London, can expect to live to 84
A boy born in Manchester can expect to live to 71
A boy born in Rutland can expect to live to 80
Source: Healthcare Commission
However, it is a different picture in Wales. Some 8,457 people there were waiting over a year for a hospital operation at the end of March. Of these, 1,401 were waiting longer than 18 months.
The report confirms that the NHS is making progress against major diseases like cancer and heart disease.
Deaths from cancer fell by 13% between 1993 and 2001. Deaths from heart disease and strokes fell by 23% between 1995 and 2002.
However, the report also reveals that there are still wide variations in health across England and Wales.
For instance, a baby boy born in Manchester can expect to live until he is 71. A baby boy born in Rutland can expect to live to almost 80.
A person living in Liverpool or Tower Hamlets in London is much more likely to die from cancer than someone living in east Dorset.
People on lower incomes are more likely to suffer a long term illness or disability compared to those with higher incomes.
Variations across the NHS
Patients in Wales can wait over 18 months for a hospital operation
Few patients in England wait more than nine months for a hospital operation
People from black and ethnic minorities are more likely to be detained in a mental health unit
The chances of an elderly person getting a flu vaccine can vary depending on where they live
Source: Healthcare Commission
There are also major differences in the way the NHS treats people from certain groups.
For instance, people from black and other ethnic minority groups are much more likely to be compulsorily admitted to a mental health unit than whites.
In some parts of the country, over 70% of older people are immunised against flu. In other parts, the figure is just 50%.
The report suggests that immunising all older people could save nearly 5,000 lives a year in England alone.
The commission also raises questions about how the government allocates money to the NHS in different parts of the country. It says some of the most deprived areas are not getting as much as they should.
Health Secretary John Reid said the government was committed to stamping out these variations.
"Inequalities are a continuing scar on civilised society," he said. "They are unacceptable."
Mr Reid said he would soon be starting work to make sure that funds were more fairly distributed across the NHS.
"I will want to concentrate that redistribution towards those in the greatest need and with the greatest deficit," he said.
Opposition parties used the report to criticise the government's health record.
Shadow Health Secretary Andrew Lansley, said: "It is truly shocking that such a health divide still exists between the rich and poor.
"Labour has failed completely to ensure that resources reach areas with the most healthcare needs."
Liberal Democrat health spokesman Paul Burstow said: "Until this government tackles the root causes of ill health instead of simply trying to treat the symptoms, these appalling inequalities will remain."