Published: 14/04/2005, Volume II5, No. 5951 Page 10

Targets can kill. That was the claim of a major investigation by the Sunday Telegraph into the delivery of the four-hour accident and emergency target.

Under the Freedom of Information Act, the paper had accessed e-mails sent by NHS clinicians and managers from several hospitals warning that efforts to meet the 98 per cent target by close of 2004 were putting lives at risk. Meanwhile, the management approach to delivery was likened to that in Stalin's Russia.

The most alarming evidence came from an anonymous doctor in the North West: 'I have just finished working in ********* hospital and the situation there is dangerous and intolerable... A&E will not breach the four-hour targets under any circumstances - when a patient gets to three hours they must be moved to hit target.' Patients including a heart failure victim and a heroin overdose, plus cases of severe pneumonia and seizure had been put into an unsafe 'day room' which made up the hospital's medical assessment unit, she alleged.

But the newspaper seemed equally appalled by the use of jargon and management practice in the NHS: 'emergency pathway co-ordinators' and 'emergency access target executive debriefs'.

What was 'perhaps most worrying of all' (worse than lives being put at risk, then? ) was evidence that the trail of 'interference' could be traced directly to Number 10, with struggling trusts held to account by delivery unit head Professor Michael Barber.

An accompanying profile of 'Mr Targets', as the professor was nicknamed, hit a lighter note, claiming to reveal his proudest moment so far - when target culture featured in EastEnders last year. Grumpy Walford entrepreneur Ian Beale claimed that 'people spend at least five hours in A&E' only for his partner to reply: 'It is a lot better nowadays.' That, a Cabinet meeting later heard, was 'worth more than 10 ministerial speeches'.