Surgery on NHS ‘being delayed until patients die or go private’

Patients in England have a legal right to start routine hospital treatment within 18 weeks of referral by their GP.

But a study by the Co-operation and Competition Panel says minimum waiting times of 15 weeks are being imposed by some primary care trusts (PCTs) even though hospitals have the capacity to see patients sooner.

It said patients can be left in pain for longer than necessary, while others choose to go private or simply die first.

No detailed evidence of the practice is published in the report although one PCT told the panel it “sought to increase average waiting times from 13 to 16 weeks as a result of the PCT’s worsening financial position”.

Katherine Murphy, chief executive of the Patients Association, said: “It is outrageous that some PCTs are imposing minimum waiting times of up to 15 weeks.

“The suggestion that it could save money because patients will remove themselves from the list by going private or dying is a callous and cynical manipulation of people’s lives and should not be tolerated.”

Health Secretary Andrew Lansley said: “Too many PCTs have been operating in a cynical environment where they can game the system – and in which political targets, particularly the maximum 18-week waiting time target, are used to actually delay treatment.

“When GPs, specialist doctors and nurses are making the decisions, as they will under our plans, they will plan care on the basis of the clinical needs of patients and their right to access the best service, including the least possible waiting time.”

But David Stout, director of primary care trust network at the NHS Confederation, said claims patients were dying as a result of longer waiting lists were not evidenced and would cause “unnecessary public anxiety and alarm”.

Waiting times were on average eight weeks for routine inpatient care but there were some areas of the country where financial pressures had led to increases.

“The NHS has made great strides to reduce waiting times for routine care and will want to maintain this,” he said. “As financial constraints loom over the NHS, commissioners are finding they have to make difficult decisions about priorities while seeking to maintain high-quality services.

“But where these decisions are being made it is essential PCTs and doctors are clear with their patients and local communities from the outset about what services are and are not available to them, and how long they can expect to wait for treatment.”

The panel report said: “Experience suggests that if patients wait longer then some will remove themselves from the list or will no longer require treatment when it is finally offered. We understand that patients will remove themselves from the waiting list either by dying or by paying for their own treatment at private sector providers.”

When treatment was delayed, more complex and expensive care could be required so money might not be saved in the long run.

Panel chairman Lord Carter said: “Commissioners have a difficult job in the current financial climate, but patients’ rights are often being restricted without a valid and visible reason. Crucially, it is the lack of transparency that surrounds certain restrictions on patient choice that is of concern.”

In May, waiting times in Yorkshire for inpatient treatment were the third best of 10 regions in the country with waits of 7.8 weeks on average and 91.7 per cent of patients treated within 18 weeks.

Patients in North East Lincolnshire were treated on average in 5.4 weeks compared with 9.9 weeks in Kirklees. Only three in 100 patients waited more than 18 weeks for treatment in Rotherham but this rose to one in six in Wakefield where one in 20 patients waited more than seven months.

Typically patients face longer waits in highly specialist fields, if they need treatment in areas there are chronic shortages of specialists, or where local hospitals lack capacity.