Waiting list cheats

London health bosses approved the secret fiddling of hospital waiting lists, an official report found today.

The report found the hospital guilty of falsely reporting waiting list figures to the Department of Health in 2001. But, in spite of the condemnation, two senior managers criticised in the report have not been sacked and one of them remains an NHS chief executive earning more than ?100,000 a year.

The chief executive at St George's at the time, Ian Hamilton, was also revealed to have charged a ?500 dinner bill at the five-star Savoy Hotel to the trust in a clear breach of its rules.

One of the most senior figures in the NHS was also caught up in the report, which looked at a series of allegations of misconduct at the hospital over five years.

Andrew Dillon, now chief executive of the National Institute for Clinical Excellence - the body overseeing attempts to end the postcode lottery for treatments - was chief executive of the hospital in 1997. He wrote a reference for a former hospital estate manager that failed to mention the man was being investigated over improper use of his credit card. NHS fraud investigators are likely to be called in. Mr Dillon was cleared of misconduct on the grounds he followed advice from the hospital's lawyers to keep the investigation a secret.

The independent report was ordered after the scandal was revealed by whistleblower Ian Perkin, who subsequently lost his job as finance director.

The inquiry was conducted by David Sissling, chief executive of Leicestershire, Northamptonshire and Rutland Strategic Health Authority.

He found 1,159 patients were left off waiting lists in 2001 in a bid to gain St George's three-star status. This would have allowed it to apply to be a foundation hospital, giving bosses freedom to run their own budgets.

Mr Sissling found they also failed to record the number of operations that were cancelled during three weeks in September 2001. This was designed to help the hospital hit targets that it had previously failed to meet, and which executives had been warned were being closely monitored by the Department of Health. The scheme was agreed at a high-level meeting between unnamed managers who approved it despite knowing that they were not allowed to falsify figures to meet targets or improve the hospital's apparent performance.

John Parkes, who was deputy chief executive at St George's and is now chief executive of Mid Yorkshire Hospitals, is alleged to have told a junior member of staff to ignore calculations that 28 operations had been cancelled in one week and told to record it as zero. The report said: "Mr Parkes was responsible for an error of judgment."

Mr Sissling accused the hospital of having "poor managerial relationships and weak corporate oversight". It found two senior managers were virtually at war while chief executive Mr Hamilton failed to rein them in. "The dysfunctional state of the senior management team was severe," Mr Sissling said.

The report also reveals how Mr Hamilton put much of the cost of a dinner at the Savoy on his company credit card. He paid ?540.25 towards the ?1,165.25 bill for "an event" in 1999 to "thank the outgoing trust chairman".

The chairman, Elizabeth Vallance - whose husband Sir Ian was chairman of BT at the time - was treated to a ?48-a-head dinner for 15 people. They drank eight bottles of the ?19 house white and four bottles of a ?22 merlot. The guests included Sir Ian, who at the time earned ?649,000 a year.

Mr Hamilton charged the ?540.25 to the "chairman's hospitality budget". He was guilty of misusing his expense account, the report found. Finance director Ian Perkin lost his job at St George's after revealing the crisis at the hospital. He is expected to use the report to appeal against a ruling by a tribunal that refused to reinstate him.

Peter Homa, the chief executive of St George's, said: "We accept the findings of this report and will be checking to make sure that all the relevant recommendations are firmly established."