Published: 12/12/2001, Volume II2, No. 5835 Page 7

Managers rarely fiddle waiting lists but do engage in 'gaming' to meet targets, the NHS Confederation told the public administration select committee.

Confederation chief executive Dr Gill Morgan denied reports that one in 12 managers had fiddled their waiting-list figures. 'I think it happens occasionally, perhaps three or four cases a year nationally, ' she said.Managers who deliberately altered figures should be sacked, she said.

Much more common was for managers to play games to make sure they meet targets. 'It is much more subtle, ' she told MPs on the committee.

'If you have a woolly target such as accident and emergency waiting times, the question is when do you start the clock? That is not fiddling, but it is gaming.'

Dr Morgan said that with so many targets - over 400 for primary care trusts and 250 in acute trusts - managers had to prioritise those where their jobs were on the line. These included waiting lists, access, trolley waits and developing crisis intervention services in mental health.

In briefing notes to MPs, the confederation stated: 'In some cases there has been informal briefing by one part of the Department of Health against others about which are the 'real' targets and which can be ignored.'

Dr Morgan did not give any concrete examples of this, saying:

'It is made clear which are the really important ones.'