Attempts to conceal breaches of the 18-month waiting-list guarantee at Stoke Mandeville Hospital trust led to the resignation of the chair and three non-executive directors last week.

A visit by the National Patients' Access Team at the request of South East regional office discovered 37 breaches of the waiting time, with a further 76 cases being reviewed in five surgical specialties.

Chair Gillian Miscampbell and three non-executive directors of the trust have resigned. Alison Phillips, who has been a nonexecutive director for four years at the trust, said that Mrs Miscampbell had been forced to go by the regional office and as a consequence she herself had resigned.

Mrs Phillips said she understood mistakes had been made by junior staff in relation to waiting list numbers and that 'some patients had been inappropriately suspended'.

But she said: 'It was not something done in collusion or with knowledge of senior management, certainly not at board level. '

She said she did not defend the breach of the 18-month waiting list guarantee, which was reported to the regional office as soon as it first came to light.

But the hospital had been operating without a chief executive for the best part of a year, was running at 98 per cent capacity and almost continuously at 'red alert', she told HSJ.

Mrs Phillips described the Department of Health as giving 'political dogma and expediency' a higher priority than the need to support and sustain the continued delivery of outstanding clinical services.

On behalf of the trust, David Custerson, director of corporate affairs at Buckinghamshire health authority, said that once a joint action plan between the trust and HA had been agreed by the regional office next week, the question of calling others to account would be considered.

The regional office claimed the review showed that the problems had been caused by a 'fundamental failure of systems over a long period'.

It found there was a 'lack of knowledge and expertise in management of waiting lists, exacerbated by poor information systems'.

Ruth Carnall, regional director of South East regional office, said:

'It is quite unacceptable that patients should wait more than 18 months for treatment. ' She said that 'firm action' was being taken to ensure these patients were treated as quickly as possible and that waiting-list management at the trust was strengthened.

Aylesbury Vale community health council chief officer Jenny Hunt said the number of long waiters, together with the issue of concealment, was 'absolutely appalling'.

She said the CHC had been in discussion with the trust about waiting-list issues for some time and questions asked at board meetings about the trust's capacity had not been satisfactorily answered.

Described by local Conservative MP David Lidington as 'a fearless champion of Stoke Mandeville Hospital', Ms Miscampbell had been chair for six years.

Her successor is Dr Anthony Woodbridge, a solicitor who has been chair of Harrow and Hillingdon Healthcare trust since 1994.