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Last Updated: Friday, 11 February 2005, 11:41 GMT
The waiting game
By Nick Triggle
BBC News health reporter

Surgery (generic)
Just over 80 patients are waiting over nine months for an operation

Down, down, down. For the past six years Labour has overseen an almost continuous fall in hospital waiting figures.

Tony Blair sees the achievement as such a trump card that he has included it as one of the government key six election pledges, promising patients will be treated "better and faster".

The waiting list peaked in mid 1998 at 1.3m but in November last year it reached a record low - 843,900 - since the data started to be collected in such a way in September 1987.

The latest figures for December, released on Friday, showed a slight increase but that is common at this time of year.

Long waits

Patients facing long waits have also fallen dramatically. At the end of the 1980s nearly 100,000 were waiting over two years for treatment.

At the time of the NHS Plan in 2000, 125,000 people were waiting over nine months.

Now the number stands at just 86.

But is this too good to be true and how long can it really continue?

Making sense of hospital waiting
Hospital waiting lists have fallen by more than a third since a peak in 1998
Waiting times are also at their best-ever level with just 86 patients waiting more than nine months - five years ago it stood at 125,000
But other figures suggest the average wait has increased by five days since 1999
Up to two thirds of a patients "true" waiting time is spent waiting for diagnostic tests, which have not been included in the official figures

To date patients have only been classed as waiting after diagnosis, meaning long-delays for diagnostic tests post GP referral have not been included.

In some cases, a wait for a diagnostic test can account for two-thirds of the overall wait.

A Liberal Democrat survey last year of 158 hospital trusts found patients were waiting for up to six months or more in two fifths of hospitals for routine MRI scans.

Liberal Democrat health spokesman Paul Burstow said these amounted to "hidden waits"

"The extra investment going into the NHS is delivering results in terms of maximum waiting times.

"But Labour have been obsessed with the statistics to the point when they come first above quality patient care."

Research by the Conservatives indicates a similar story. Using Department of Health figures, called hospital episodes statistics, the Tories have said they have proved average waiting time has actually increased by five days since 1999.

'Distortion'

Shadow Health Secretary Andrew Lansley said he had written to the NHS chief executive Sir Nigel Crisp to point out that Labour had been distorting the figures.

He said he was still waiting for a reply, adding: "Blair's government are not giving a full and rounded picture."

Last June Health Secretary John Reid sought to answer the criticism by saying he would include the diagnostic waits in the three-month target for 2008.

But some say this is where the government could come unstuck.

Patients Association chairman Michael Summers said he wanted to see a continuing fall in waiting lists.

I think in the UK, where we do have a long history of waiting lists which dates back to the birth of the NHS, the public would be happy with a wait of three months
Tony Harrison, of the King's Fund

But he added: "What patients don't want is to see urgent cases left waiting or people left stranded before diagnostic tests."

Mr Summers said that ensuring this did not happen could hamper the government in its aims.

However, others believe waits could carry on falling regardless.

In Germany hospital waits are almost unheard of. It only takes a patient a few weeks to be admitted to hospital once they have been seen by their doctor.

Tony Harrison, a researcher at the King's Fund, a health think-tank, said it is possible the UK could follow Germany's example.

Pressure

"Germany has achieved it through investment, if you spend enough money it is possible.

"But you have to ask, is the money best spent elsewhere?

"Once the three-month target is achieved, the government may well decide it needs to put money into other areas of the health service."

Mr Harrison also believes small waiting lists are necessary if you want the NHS to work at full capacity.

"If you had no waiting list it would mean you would have times when people were not working so they would be ready to give treatment immediately when it is needed.

"Really you would need to have a waiting list of a few weeks to ensure the NHS was efficient.

"I think in the UK, where we do have a long history of waiting lists which dates back to the birth of the NHS, the public would be happy with a wait of three months."

Desirable

And King's Fund chief executive Niall Dickson said that if the government did continue to pursue hospital waiting it could have an impact on improving other services such as "mental health, public health and chronic illness".

Dr Jonathan Fielden, deputy chairman of the British Medical Association's consultants committee, also agreed some degree of wait was desirable.

"If you get to the point where people are seen straightaway, you do not give patients the time to make decisions about what is clinically appropriate and make arrangements such as child care and time off work.

"There is a bottom line. But the problem is that waiting lists have become political.

"To politicians it is about numbers, they have certainly fallen, but doctors are concerned that patients who need urgent treatment can be forced to wait because of the need to meet a target.

"Doctors and patients are bothered about quality."

And this, it seems, is where the waiting list success story could come unstuck.




VIDEO AND AUDIO NEWS
Labour's NHS waiting time election pledge



SEE ALSO
NHS waits are Lib Dem 'priority'
20 Jan 05 |  UK Politics
NHS chief upbeat about progress
03 Dec 04 |  Health

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