The health service could perform another 300,000 operations a year but for bureaucracy and bungling by hospital management, a scathing report by the public spending watchdog reveals today.

The health service could perform another 300,000 operations a year but for bureaucracy and bungling by hospital management, a scathing report by the public spending watchdog reveals today.

The Audit Commission's damning findings highlight the problems facing the Government as it attempts to drive through reform of the NHS in return for its £40bn Budget boost for health.

It discovered that operating theatres lie empty for about 10 per cent of the time they could be used. Some hospital trusts perform barely two-thirds of the operations they could perform if they managed their resources more effectively.

About 3 million operations a year are performed in England and the latest hospital waiting-list figure stands at 1,034,700. Were hospitals to use operating theatres more efficiently, lists could fall sharply. It would also save trusts money as under the NHS plan patients are offered a choice, including private treatment, if operations are cancelled.

The commission warned hospital managers: "All is not well in our operating theatres ... despite all the money and effort that has been put in to making them run like 'well-oiled machines', many are still less effective than they should be.

"With good management and information, some trusts are running 95 per cent of theatre sessions scheduled. But many operating theatres are less efficient than they should be – on average, 10 per cent of theatre sessions are cancelled and cannot be re-used."

The commission blamed the cancellations on poor forward planning, often failing to cater for surgeons taking leave at short notice. Below-standard information systems warning of future problems were also to blame.

Philip Brough, health specialist at the commission, said: "The top 25 to 30 trusts are managing to run 95 per cent of their sessions. If the performance of the rest could be brought up to that level, then half of that 300,000 shortfall could be accounted for."

The Department of Health said that, although operating theatres were not being used to their full extent, less than 1 per cent of scheduled operations were cancelled. A spokeswoman said: "At the same time as we build more hospitals, recruit more staff and put more beds into the NHS, we have to make sure that existing capacity in operating theatres is being properly used. That's why in March last year we launched an £8.5m plan to improve the way theatres are used."

The commission's findings follow two other reports illustrating poor standards on the NHS front line. Figures from the Office for National Statistics show that productivity in the health service fell sharply from 1995 to 2000, despite record investment, while two in five patients told the pollsters NOP that they had seenpoor hygiene in hospitals.

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