THE NUMBER of people waiting for in- patient or day case hospital treatment is greater now than almost five years ago, according to a report out today, writes Steve Bargeton, poltical editor.

In September 2005 there were 109,992 patients waiting for inpatient or day case treatment, compared to just under 107,000 in March 2001.

A major report by Audit Scotland— Tackling Waiting Times In The NHS In Scotland—also expresses concern at the increase in the number of people with no waiting time guarantee, a so-called availability status code (ASC).

In September 2005, there were 35,048 patients with an ASC waiting for inpatient or day case treatment, up from 28,349 in June 2003. Two thirds of these patients have been waiting for longer than six months.

Overall, Audit Scotland said the NHS in Scotland is having some success in cutting long waiting times, but warns that meeting future targets will be “challenging.”

“The NHS in Scotland has made substantial progress in tackling the longest waits but faces pressures that will make future targets challenging to meet,” said deputy auditor general Caroline Gardner.

“It needs to do more to develop approaches that work across the whole health and community care system to tackle waiting times.”

The report notes that the number of people with guarantees waiting longer than six months for inpatient or day case treatment has fallen from 11,573 in March 2001 to 1249 in September 2005, a drop of 89%.

The total number of people with guarantees waiting over six months for their first appointment fell from 53,579 to 11,854 between September 2004 and September 2005, a decrease of 78%.

But the report is concerned that the abolition of ASCs at the end of 2007 and a reduction in the maximum waiting time from six months to 18 weeks will put pressure on future waiting time targets.

On developing approaches across the whole health and community care system to tackle waiting times, the report says, “The Scottish Executive should review the balance of its funding between the longer-term development of such whole system approaches and system redesign, and shorter-term approaches to meet current targets.”

A survey undertaken for the report found that two-thirds of patients currently waiting would travel for earlier treatment, but only about 5% have been offered this.

Audit Scotland also suggests that the NHS could use the Golden Jubilee National Hospital in Clydebank more efficiently to reduce the longest waiting times.

The report notes that although the hospital exceeds its total activity targets, in some specialities not all the capacity is used. This, along with factors such as the way it pays doctors, means its costs are high compared with the rest of the NHS in Scotland.

Health minister Andy Kerr said “substantial progress” had already been made in tackling the longest waits and pledged that the Executive would meet new targets.

He added, “Nine out of 10 Availability Status Codes are patient-driven—patients not turning up or declining admission for personal or social reasons, or patients who have a medical condition which prevents treatment.

“Nevertheless, we want a more transparent system, and have already made it clear that ASCs are to be abolished by the end of 2007. All NHS boards have detailed plans in place to ensure this commitment is delivered.”

He said that in its last year as a private hospital, the Golden Jubilee National Hospital undertook 2500 procedures but is on target to undertake 10 times that figure.

SNP deputy leader Nicola Sturgeon said, “The report makes clear that ‘the total number of people for inpatient and day case treatment has changed little in the last two years’ and that ‘the NHS faces a major challenge in meeting more ambitious waiting time targets in the future’.

She added, “Andy Kerr must now acknowledge that those on hidden waiting lists cannot be ignored any longer.”

Tory health spokeswoman Nanette Milne said, “Andy Kerr has today been quick to shout from the rooftops that some targets have been met, but what he fails to realise is that these targets are in fact the problem, so achieving them doesn’t solve anything.”