Waiting lists show the scale of the task facing the NHS

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That waiting lists in NHS hospitals in England have grown by 5,000 to 1,038,000 is a daunting statistic in itself.

That waiting lists in NHS hospitals in England have grown by 5,000 to 1,038,000 is a daunting statistic in itself. It is even more awesome when it is set against the Government's own ambitious target, outlined in the NHS National Plan, of abolishing waiting lists completely by 2005, by which time it is hoped that all patients will have been given a definite booked date for treatment. Ministers found it difficult enough to fulfil their 1997 manifesto pledge to reduce the lists by 100,000. They eventually managed it, but not without wrangling about the numbers and some unacceptable distortions in clinical priorities.

The problem, fundamentally, is one of resources, and, more precisely, capacity. The public know, from their own experiences and those of their friends and family, that care in the NHS can match the best in the Western world, but that it too often approaches the other extreme. Almost every winter we see the extra demands on the NHS bring the system to the verge of collapse. During the election campaign, angry patients and their relatives rightly took every opportunity they could to tell the Prime Minister and the wider public about the reality of exactly how poor care in the NHS can be. This week's nationalisation of a private heart clinic confirms the picture of a service desperate for bedspace.

Can the Government deliver? It certainly wants to. The NHS plan envisages 7,000 extra beds, 7,500 new consultants, 2,000 more GPs, 20,000 more nurses, 6,500 other professionals and miscellaneous improvements ranging from cleaner wards to Loyd Grossman's recipes for meals. And, in successive budgets, Gordon Brown announced genuinely impressive increases in NHS spending – about 35 per cent in real terms by 2005. The problem is that it takes time to recruit and train professionals and that, in the meantime, the NHS will probably simply swallow the extra cash without very much effect on the ground, targets or not.

Ministers, particularly the health secretary, Alan Milburn, are well aware of this, and are even more acutely conscious of the political price that the Government will pay for a failure to "deliver". Initiatives like the national plan and a willingness to take on the vested interests show determination. But we suspect that they will have to find more imaginative solutions, and specifically to draw on the best aspects of health care in other EU nations such as France, or they will face more headlines about "Britain's Third World Wards".

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