NHS 'waiting list buster' Peter Homa has defended managers against Conservative claims that the record 45,000 drop in waiting lists announced last week was achieved by dubious methods.

Tory health spokesman Philip Hammond's attempt to pour cold water on health secretary Frank Dobson's good news was also attacked by managers' leaders.

Mr Hammond claimed that the government had manipulated the figures to show a massive fall, and accused managers of removing patients from lists through 'administrative ruses'.

Managers were acting under 'extreme political pressure', having been warned they would be sacked if they failed to deliver on waiting lists, he alleged.

Mr Homa, head of the National Patients' Access Team, insisted the figures were valid. 'Managers and clinicians are entitled to feel dismay at these claims.

'The government's methodology is entirely consistent with approaches used hitherto, and there have been no changes in the way in which information is counted at trust and health authority level, or in the validation of lists,' he told HSJ.

The government's list-busting team has visited 25 hospitals since May. 'I can assure you I have seen no evidence of any unacceptable manipulation of lists, and there's no sense that people are working under unacceptable political pressures,' said Mr Homa. 'Policy is clear: selection of patients must be determined by clinical priority. Staff should be applauded and their hard work recognised.'

NHS Confederation policy manager Tim Jones said the practices Mr Hammond found objectionable, such as writing to patients to ask if they still required treatment, were 'routine' list validation methods. 'We did even more of it when the Patient's Charter was brought in because fundholders required validated figures to balance their budgets.' Mr Jones said managers' handling of waiting lists had improved under the current government.

Chief executives were under 'immense' pressure, he confirmed, but their jobs also depended on performance in other key areas such as beating the millennium bug.

Institute of Health Services Management director Karen Caines said the record figures had come about through the injection of extra money backed by a 'fierce government fiat'. She added: 'Squabbles about the validity of waiting list figures are wearisome.

'Simultaneous publication of the number and type of treatments completed for waiting list patients would provide a useful reality.'

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