Hospitals told to cut out-patient queues by 2001

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EVERY NHS hospital was given notice yesterday to cut the queues for out-patients within a year as the Government published figures showing waiting times are continuing to grow.

At the end of September, 512,000 people were waiting more than 13 weeks for a first out-patient appointment after being referred by their GP, a 74 per cent rise since Labour came to power. The figure has now risen in every quarter except one since June 1997, when the total stood at 295,000.

Alan Milburn, the Secretary of State for Health, said yesterday that the rise was slowing. The latest figures for the September quarter showed 149,000 people waited more than six months, up 3,000 (2.6 per cent) on the previous quarter, compared with the 18,000 increase (16 per cent) in the same quarter of last year. "These figures suggest we are turning the corner. I am determined to build on that momentum," he said.

The new drive to cut the waiting times reflects government embarrassment at the way the out-patient queues have lengthened as in-patient waiting lists have fallen. Opposition MPs have claimed that delays at the out- patient stage are preventing patients getting on to the waiting list for operations, artificially shortening the in-patient lists. Mr Milburn insisted that the slowing in the rise in the out-patient queues at a time when in-patient waiting lists were falling answered those critics. "This gives the lie to the claim that one will always be at the expense of the other."

More than 11 million people are expected to attend out-patients this year and three-quarters of first appointments are seen within 13 weeks. A list of five measures to cut the queues, based on a survey of 20 health authorities and trusts, and pilot studies in two trusts, was published by the health department yesterday. They include new booking systems allowing patients to choose the date and time of their out-patient appointment four weeks before it is due, to reduce the toll of missed appointments.

The report recommends a manager be appointed in each trust to target clinics with the worst records and to implement long-term plans for getting the lists down with health authorities and GPs. Every trust will be required to produce an outpatient improvement plan by next March.

Mr Milburn said the problems were concentrated in a minority of NHS trusts, numbering "several dozen", and in three specialties - orthopaedics, ophthalmology and plastic surgery. But he refused to be drawn on whether private practice, which is concentrated in those specialties, was responsible for the long waits. "None of this is rocket science. It involves plain good management and the report shows it can reduce waiting times by up to 40 per cent. This is the first time we have focused on out-patients. It has been a Cinderella part of the NHS and that is changing," he said.

The chief executive of Basildon and Thurrock NHS Trust, Sue Jennings, who was namedyesterday as the new "waiting list buster" for the NHS, said hospitals would have to work evenings and weekends to accommodate patients' wishes. "There is no reason why we should not hold clinics out of hours," she said.