NHS told it must treat more patients to cut waiting times

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The longest queues for hospital treatment are coming down but progress towards cutting waiting times overall has almost stalled, ministers said yesterday.

The longest queues for hospital treatment are coming down but progress towards cutting waiting times overall has almost stalled, ministers said yesterday.

The slow pace of advance is threatening the prospect of meeting a main government target to cut hospital waiting lists to a maximum of six months by 2005, the likely date of the next election.

It will also raise eyebrows at the Treasury, which is seeking reassurance that the billions of extra investment over the past three years are producing real gains in the health service before committing itself to further massive injections of cash, expected in Gordon Brown's Budget next week.

A progress report on the NHS published yesterday shows that the biggest problem now facing ministers is how to increase the number of patients treated to ensure that waiting lists continue to fall.

While advances have been made on many fronts in speeding treatment, the central task of cutting waiting times is proving harder to achieve.

Nigel Crisp, the NHS chief executive, said targets for eliminating the longest waits by the end of last month were almost met – only two patients were waiting more than 15 months for an operation at the end of March compared with 10,400 a year ago and 500 were waiting more than six months for an out-patient appointment compared with 81,800 a year ago.

Fewer people faced long waits in accident and emergency departments, delays in discharging patients from hospital had been cut and ambulances were responding more quickly to 999 calls. There were more staff, 29 new hospitals approved or under way and 1,200 extra acute hospital beds.

Despite these gains, the reduction in average hospital waiting times had been marginal – from 18 to 17.6 weeks for in-patients and from 11 to 10.5 weeks for out-patients, a reduction in each case of about three days.

In a new charm offensive, Alan Milburn, the Secretary of State for Health, went out of his way to praise NHS staff instead of blaming them. "Real and steady progress has been made," Mr Milburn declared, saying NHS staff up and down the country had "made these improvements happen". But the seriousness of the situation was underlined when Mr Crisp admitted new targets had been set for NHS trusts for the first time this year to increase the number of patients treated.

To get waiting lists moving down towards the 2005 target, hospital activity (the number of patients treated) must rise by about 5 per cent a year, to keep pace with the increase in GP referrals (projected to rise by 1.5 to 2 per cent). The increase achieved last year was just 1 per cent.

Mr Crisp admitted this was a very sharp rise to demand from NHS trusts. He said: "We need to expand activity by creating more facilities, employing more staff, paying for more care in the private sector and ring-fencing services."

Mr Milburn, paving the way for next week's Budget and publication of the final report by Derek Wanless on NHS funding, ruled out alternative systems for paying for the NHS through social insurance, private insurance or charges.

"My message to the people working in the NHS and to the public who pay for it is this: the best route to secure better health care for our country is a reformed health service with higher health spending."

Evan Harris, the Liberal Democrat health spokesman, attacked the Government's "target culture". Of 35 NHS targets set in the comprehensive spending review for 1999-2002, only seven had been met and five were on course to be met, he said.