Pressure leads doctors into spin

Convincing the public the NHS is improving has long been a Government priority.

Health chiefs hoped that publishing regular figures on waiting times for treatment would provide the proof.

But the intense pressure on hospital managers to hit targets has undermined the policy - with a succession of scandals over "fiddling" of figures.

Allegations of deliberate distortion of patient records by hospital managers became so rife last year that the Government launched an inquiry. The investigation by the Audit Commission, published this time last year, found that a third of all hospitals were manipulating waiting-list figures, providing a highly misleading impression of how the NHS is performing.

The most damning evidence of the practice in London involved St George's Hospital. Earlier this year, insiders told how managers used a bureaucratic loophole to avoid recording thousands of operation cancellations.

Dr Nizam Mamode, deputy chairman of the British Medical Association's consultants' committee, has claimed that the practice is widespread in NHS hospitals, with the "majority" using deceptive tricks.

Despite the claims, managers remain under intense pressure to meet Government targets.

Doctors claim the policy encourages staff to carry out the quickest and easiest operations first, rather than those that are most urgent in terms of patient welfare.