NHS Trusts are deliberately delaying operations hoping that patients will either go private or die waiting, according to an official report published yesterday.

The Co-operation and Competition Panel highlighted "endemic" unfair practices in care delivery in parts of England as health trusts come under pressure to cut £20bn in expenditure over the next four years.

Primary Care Trusts (PCTs) impose "pain and inconvenience" by making patients wait longer than necessary for operations, hoping they will leave waiting lists "either by dying or by paying for their own treatment," claims the report, details of which were published today in the Daily Telegraph.

One concerning tactic used by Primary Care Trusts is blocking patient choice, with half of the 151 PCTs guilty of the practice, according to the report. "Commissioners have a difficult job in the current financial climate, but patients' rights are often being restricted without a valid and visible reason," said the panel's Chairman, Lord Carter of Coles.

Two-thirds of health trusts in England are rationing treatments for "non-urgent conditions" including hip and knee replacements and cateract operations, The Independent revealed yesterday.