wait watcher: The NHS is on target to keep its promises over reduced waiting times. So what's that got to do with Victor Meldrew? John Yates explains

Published: 13/06/2002, Volume II2, No.5809 Page 23

Patients, politicians and the press continue to keep a watchful eye on the NHS, on the lookout for any gap between promise and delivery. It is now almost two years since the NHS plan set a number of targets about waiting times and, having reached the end of another financial year, it is time to find out where we stand.

The March 2002 English figures were eventually published on 10 May (with and without Bath, which is presumably going to be encouraged to apply for independence). Encouragingly, the figures show signs of movement towards target. The number of outpatients waiting more than 13 weeks fell to 194,700, the lowest figure since Labour came to power in 1997.

Similar news came on the inpatient front, with those waiting more than six months down to 241,200, also the lowest point since Labour came into office.

Figures 1 and 2 chart the progress made against the sort of projected lines that need to be maintained to ensure that by 2005 no patient breaches the 13-week or six-month waiting periods. The outpatient performance is well ahead of schedule, and even the inpatient performance is close to the projected reduction target. This ought to be cause for satisfaction, if not unbounded celebration.

Many NHS staff and patients, however, still adopt the Victor Meldrew stance when seeing the Department of Health data. Throughout the country one can hear the phrase: 'I do not believe it!'

It is in the outpatient figures that one has some sympathy with this scepticism. Looking at figure 1, the March figures catch the eye. The March quarter figure is always lower than the preceding December quarter although, in fairness, this could be explained by seasonal variation. In the past three years, however, the March quarterly drops have been huge - 93,835, 115, 309 and, now, 166,358.

These drops are quite out of line with any other quarterly fluctuation. Some of this is explained by the surge in extra activity and additional clinics which many trusts set up to ensure the year-end figures look good, but can it all be explained by hard work? Why did the 2000 and 2001 June quarter figures bounce back by 42,659 and 75,692? Will we see a similar bounce back yet again? The April 2002 figures are awaited with interest.

While scepticism about the figures is understandable, given the examples of fiddling that have come to light, we should keep a balanced perspective. Many parts of the NHS have worked hard to reduce waiting times and it is unfortunate that their efforts are belittled by those who extend their scepticism to all the data.

There are signs of real progress, but no-one should delude themselves about the magnitude of the task ahead. It will not be easy to ensure that the 250,000 people currently waiting more than six months for treatment, and those who will take their places in the queue, are quickly removed from the lists.

Professor John Yates is director of inter-authority comparisons and consultancy at Birmingham University's health services management centre.