Progress on waiting times but more needed

Thursday, 4 August 2005 12:00 AM

The government is likely to meet its 18-week waiting time target for NHS hospital treatment by 2008, a report from the King's Fund says today.

Labour inherited a waiting list of 1.3 million people and a maximum waiting time of 18 months when it came to power in 1997, but the independent health body finds efforts to cut it have been largely successful.

However, it says ministers must now look at how to broaden their focus to ensure people are getting the right treatment within that timeframe, saying "unacceptable differences" in the quality of clinical practices still remain.

"The government is moving in the right direction on waiting times but should use the next two to three years to prepare to go further," report author Anthony Harrison said.

"Waiting time targets are based on assumptions that are rarely made explicit: namely that the right people are being identified and referred for the right treatment at the right time.

"Yet we know that access to some non-emergency surgical treatments is lower for people from poorer communities compared to those who are better off, and that the clinical criteria by which patients are treated vary from area to area and even doctor to doctor.

"More work is needed to determine the scale of the current variations, the reasons for them and the policies likely to be effective in tackling them. But as the 18-week target is approached, the government should put much more emphasis on doing just that."

Shadow health secretary Andrew Lansley welcomed this call for a wider focus, saying it was vital to know how the 18-week target is going to be measured.

"What we need is flexibility so that patients are treated according to need, not some political target. This would enable hospitals to fast-track more serious cases over non-urgent ones," he said.

King's Fund chief executive Niall Dickson warns, however, that while waiting lists are likely to fall and extra capacity be provided by the private sector, "nothing should be taken for granted".

"The sheer number of patients to treat, the worsening financial climate, the uncertain impact of payment by results and choice, and shortages of staff in key areas all present real challenges for the government and the NHS," he said.

Liberal Democrat health spokesman Steve Webb said this emphasis on better planning was vital if current NHS reforms were not to upset the whole process.

"There is a danger that the 'market mania' in the modern NHS will actually increase waiting times. Shopping around by patients makes it hard for hospitals to plan carefully or make best use of precious resources," he said.

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