The number of people waiting for hospital treatment rose by 3.4% in December - with the flu crisis set to push up the figure even further in January.

The total number of patients waiting to be admitted to NHS hospitals in England rose by 36,600 between the end of November 1999 and the end of December 1999. The total number waiting is now 1,108,000.

The rise is the first for six months and the biggest for more than a year. Official figures for January are almost certain to show an even bigger jump as the NHS struggled during the month to cope with an upsurge of demand.

The number of people waiting more than a year for treatment also rose by 1,900 to 51,300.

And 101 patients had waited more than 18 months, in breach of the Labour promise that no one would have to wait that long.

The government has pledged to cut inpatient waiting lists by 100,000 from the level of 1,158,400 inherited from the Conservatives at the general election in 1997 in the lifetime of this parliament.

Health Minister John Denham said the rise was to be expected, and chose instead to focus on the first fall for three years in the number of people waiting for an outpatient appointment.

Figures show the number of patients waiting more than 13 weeks to see a specialist after GP referral fell by 16,000 between September and December 1999.

Between April and December last year there were 8.1million first out-patient appointments, 160,000 more than for the same period in 1998.

Critics claim government pressure to reduce inpatient waiting lists has simply led to more people being made to wait longer for a first outpatient appointment - which must take place before they are added to the inpatient waiting list.

Mr Denham said: "We are starting to turn the corner on outpatient waiting. Outpatients waiting lists usually rise this quarter."

Mr Denham said new booking systems would be set up for outpatient departments to allow patients to choose a time and date which is convenient to them.

Other initiatives soon to come on stream include "one-stop" outpatient services, call centres for patients to check their appointments and new arrangements for patients and their GPs to book hospital appointments directly.

Mr Denham said inpatient lists had risen as a result of planned reductions in admissions, allowing hospitals to give priority to winter pressures.

He said: "The rise in inpatient waiting lists gives the lie to those who say the work of the NHS is being distorted by the manifesto target. This winter the NHS did the right thing - it put the increased pressures before elective cases.

"Once emergency pressures subside, the NHS will make further progress in cutting waiting lists. The manifesto target will be met."

Conservative health spokesman Dr Liam Fox said: "We warned the government that their obsession with waiting list initiatives and running the system with no slack for common and predictable occurrences, such as winter flu, would have major ramifications for the NHS.

"Now their own targets are being blown off course by their own incompetence.

"Sadly, the price is never paid by the politicians, but by the patients who are made to wait even longer under this government."

The NHS Confederation, which represents health authorities and trusts, said the rise in inpatient waiting figures demonstrated the need for further investment to increase the capacity of the NHS to cope with peaks of demand while continuing to carry out routine surgery and provide other services.