No deliberate manipulation of NHS waiting times says report


  By a Newsnet reporter

An investigation into waiting times in the Scottish NHS has found no evidence of deliberate manipulation.

The conclusion by Audit Scotland comes after problems emerged at hospitals in NHS Lothian and in Tayside.

The investigation found a small number of cases where patients had been inappropriately recorded as being unavailable for treatment when it was not the case, but said there was no evidence to back up claims that the practice was deliberate.

Last year, then health Secretary Nicola Sturgeon ordered a nationwide investigation into waiting times in Scotland after it emerged bosses at NHS Lothian had been removing some patients from lists if they declined to travel to England for treatment.

Concerns were also raised after some staff in NHS Tayside complained of being under pressure to mark some patients as unavailable in order to meet waiting time targets.

In December last year, Scottish Labour Health spokesperson Jackie Baillie claimed that Scottish Labour knew that, “health boards have been fiddling waiting list figures and patients have suffered delays to treatment.” The MSP claimed the practice was “more widespread” than NHS Lothian.

Attacking Scottish NHS funding she added: “These cuts have helped to create an environment which forces staff to manipulate systems.”

However the conclusion that there was no evidence of widespread manipulation of waiting time figures will be seen as blow to Scottish Labour and a victory for the Scottish government who had faced claims that health boards across Scotland had been deliberately fiddling waiting time lists.

According to the report: “Audit Scotland found a small number of instances where unavailability codes were used inappropriately,

“Due to the poor information, it was not possible to determine whether these were due to human error, inconsistent interpretation of guidance, or deliberate manipulation.”

Scotland’s auditor general, Caroline Gardner, said: “The management and scrutiny of the waiting-list systems have not been good enough.

“During the period we reviewed, the Scottish government and boards were focussed on making sure waiting times targets were being met but not giving enough attention to how this was being done.

“Better scrutiny of the increasing use of social unavailability codes could have highlighted concerns earlier. It also could have identified where waiting times pressures were building in the system.”

Welcoming the report, Health Secretary Alex Neil said the recommendations included had already been implemented last October: “We welcome this report that shows there are no examples of manipulation of the figures like those found at NHS Lothian,”

He added: “Health boards’ own internal audits also found no evidence of manipulation.”

Responding to today’s report, Labour health spokeswoman Jackie Baillie said: “This report makes clear that hidden waiting lists were widespread, not just in Lothian, and the SNP government was aware there was a problem and did nothing.

“It preferred to believe its own spin and hype than concern itself with what was really going on in our hospitals.”

However SNP MSP Bob Doris warned that if Labour had their way, patients who were too ill for treatment or unable to attend their appointment would be left languishing without treatment indefinitely, instead of being seen promptly under the current system.

Mr Doris also highlighted previous Audit Scotland reports which welcomed the changes made by the SNP Government, and praised the new way of measuring waiting times.

In June 2010 Audit Scotland ‘Managing NHS waiting lists – A review of new arrangements’ said: “We found that the NHS has done well to implement the new arrangements, and people no longer remain on waiting lists indefinitely.” (Page 1)

In June 2011 Audit Scotland ‘Measuring NHS waiting lists Twelve-month summary impact report’, said “This audit provided assurance that the new arrangements are generally working well. The Scottish Government has developed further guidance about the areas where we raised concerns such as the treatment of patients who do not or cannot attend their appointments. ISD Scotland is continuing to work with NHS boards to improve the quality of New Ways data. There should not be any need to conduct a follow up study in the foreseeable future.” (Page 6)

Commenting, Mr Doris – who is Deputy Convener of the Scottish Parliament’s Health Committee – added:

“Even by Labour’s standards, these comments are unbelievably hypocritical. The fact of the matter is that under Labour any patient who was too ill for treatment, on holiday or couldn’t attend was abandoned with little prospect of treatment.

“Under the scheme introduced by the SNP Government, which abolished the practice of leaving people languishing on hidden waiting lists,  people are treated when they are able and waiting times targets are being met.

“It seems Jackie Baillie would rather people were left languishing indefinitely than properly treated by our excellent NHS.”