NHS waiting list pledge to be dropped

THE GOVERNMENT is to abandon its drive to reduce NHS hospital waiting lists once its manifesto pledge to lop 100,000 off the queue has been achieved.

The Department of Health is expected to announce this week that its target has been passed, fulfilling the most expensive and onerous of the five key pledges made during the election campaign in April 1997. No new targets for further cuts will be set.

The Government is eager to dump the promise, which has proved an expensive, heavily- criticised millstone round the NHS's neck. The British Medical Association says it has distorted clinical priorities as patients with minor conditions have been treated ahead of those with serious problems.

Ministers have privately admitted the pledge was a mistake and are eager to discuss a new approach focusing on waiting times rather than on the length of the list. A Whitehall source said: "Once the target has been reached, breached and pushed further, we will be able to have a more sensible and open-ended neutral discussion on the way forward because it is waiting times we want to bear down on."

Reversing the rise in NHS waiting lists, which climbed from 1,157,700 at the time of the 1997 general election to a peak of 1,312,700 in April last year, before falling back to 1,072,500 in March - just 15,000 short of the manifesto target - has been a colossal task. It has cost more than pounds 600m, operating theatres have been kept open and surgeons have worked nights and weekends, earning tens of thousands of pounds in bonus payments.

Frank Dobson, the Secretary of State for Health, praised NHS staff last Friday for treating 450,000 more in-patients and 600,000 more out- patients last year.

When next week's figures are announced, they will show that the NHS waiting list for England, which rose by more than 150,000 during Labour's first year in office, fell by more than 255,000 in the second, the fastest drop in NHS history.

The average wait for an in-patient operation has come down from more than 3.5 months before May 1997 to 2.9 months. But opposition parties have claimed that the wait for treatment has been pushed back, reflected in the rise in out-patient waiting lists. The Liberal Democrats will today release figures underlining this.

There has been a fourfold increase in women waiting more than six months for gynaecological outpatient appointments and nearly a three- fold increase in patients waiting six months to see an ear nose and throat consultant. In the North West, patients waiting more than six months to see any specialist have risen threefold. The total number of out-patients waiting over three months has risen by 208,000 since the election.

Simon Hughes, the Lib Dem health spokesman, said: "The message is clear: don't get sick in the North West, don't expect to see an ENT specialist soon. This analysis shows Labour's pledge has been met by dumping 200,000 NHS patients on pending lists."

The British Medical Association has called for a fairer, more transparent system based on clinical need. They suggested a four-category "severity score": "emergencies" for immediate admission, "urgent" within two weeks, "soon" within three months, and "in turn" within 12 months. A fifth category would include patients to be admitted within three months of their planned date.

Dr Peter Hawker, chairman of the consultants' committee, said that if patients knew they were waiting to let someone with a greater clinical need receive their surgery, then they would not mind waiting longer. They would be reassured that if their need was greater next time, then they would take priority on the list.