Spilling the beans

From The Guardian:

NHS hospitals across England are systematically rigging their waiting lists to make it look as if they are hitting key government targets, the Department of Health acknowledged yesterday.

It said GPs were right to complain that it was becoming harder to make bookings for patients to get hospital treatment.

Many NHS trusts are telling GPs that their lists are full over the next few weeks and refusing to make advance bookings for later in the year. By keeping the queues short, the hospitals hope to hit the government's target for reducing waiting times.

The main health pledge in Labour's 2005 election manifesto was to reduce the maximum wait to 18 weeks from referral by a GP to being wheeled into the operating theatre, with no extra time added for patients needing complex diagnostic tests. An inquiry by Pulse, a newspaper for GPs, found 90% of hospitals were restricting advance bookings. "The practice can mean patients are barred from going to the hospital of their choice, since popular hospitals may have no appointment slots available in the short term," it said.

Ministers told GPs it would be easier to make hospital appointments for patients using an electronic system known as Choose and Book. But the inquiry found hospitals are keeping up to a third of their appointment slots off the electronic register in an attempt to reduce demand. The British Medical Association said: "We have heard of similar reports from doctors across the country. We would be very concerned if trusts were putting targets ahead of patient care.

"It is ironic that when government has put great emphasis on patient choice, their own targets on waiting times are stopping some patients from choosing their preferred hospital for treatment."

The association said it had evidence of trusts refusing referrals from GPs to avoid breaching the 18-week target. "All additional referrals are returned to the GP and not passed to an alternative provider. Such a situation could be repeated, by various providers, and further delay the patient's treatment," the association said. In some cases, hospitals were refusing to treat patients until the GP had dealt with problems such as high blood pressure or excessive weight.

A Department of Health spokesman said: "Hospitals should not be doing this. They are required to accept all referrals if clinically appropriate, and should not be manipulating Choose and Book to help them meet other targets." He added: "It is right for patients that they now have more choice, allowing them to arrange appointments at times and at hospitals that suit them - however this should not be at the detriment of being seen quickly ...

"The department has taken direct action by putting in place a national system to ensure that where patients are told that there are no appointments available on Choose and Book for their chosen hospital, they are still referred on to the provider of their choice."