The government has come under renewed fire from the King's Fund for its 'misconceived' strategy on waiting lists.

A report on access to elective care, issued this week, says little progress has been made in the waiting-list debate and the current government's performance 'has fallen short of what is required'.

'It continues to try to impose on the NHS a target generally agreed to be inappropriate, not simply because it emphasises numbers rather than the times most people have to wait, but also because it ignores the other elements of the whole system of which hospital waiting lists form a part.'

The report, by Anthony Harrison and Bill New, says the government should try to 'integrate' policy that impacts on elective care, and back this with better systems for reporting times that give a clearer regional picture.

It says the information should be used to produce an annual report on the elective care system against which targets could be set for particular procedures or population groups.

'Waiting lists as currently defined should disappear from the national policy agenda to be replaced by a focus on access to hospital care.' The report wants a clearer definition of the role of the private sector, which allows a small section of the population to escape 'rationing by waiting list'.

Access to Elective Care: what should really be done about waiting lists. King's Fund bookshop, 0171307 2591.£12.99.

See politics, page 21.