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August 3 - 9 2011

News

The Telegraph

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PAGES 2-13

μWorld News PAGES 14-17

μComment PAGES 18-21

μ Letters

PAGE 20

μObituaries PAGES 22-23

μ Features

PAGES 24-26

μCulture

PAGES 27-29

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μBusiness

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PAGES 33-37

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PAGES 40-48

NEWS P11

NEWS P7

PM impatient David Cameron urges the Chancellor to kick-start economy

Soldiers’ deaths: inquest over Three British officers were ‘unlawfully killed’ in Afghanistan

CULTURE P28

OBITUARIES P22

Farewell Freud A look back at the life and work of a painter of the naked truth

Edinburgh Festival’s finest From Chinese ballet to fresh comedy and Fringe benefits

LOTTO 27/07

LOTTO 30/07

16 4 22 34 39 42 4 10 29 32 34 40

Bonus Ball 35

Bonus Ball 48

There were two winners of Saturday’s £4.6m jackpot and two winners of Wednesday’s £2.4m prize

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1045

The Telegraph

By Martin Beckford Health Correspondent NHS managers are deliberately delaying operations as they wait for patients to die or go private, in order to save money, according to an official report published last week.

Health service trusts are “imposing pain and inconvenience” by making patients wait longer than necessary, in some cases as long as four months, the study found.

Executives believe that the delays mean some people will remove themselves from lists “either by dying or by paying for their own treatment” claims the report, by an independent watchdog that advises the NHS.

The Co-operation and Competition Panel says the tactic is one of a number used by managers that “excessively constrain” patients’ rights to choose where to be operated upon, and damage hospitals’ ability to compete for planned surgery. It claims unfair practices are “endemic” in some areas of England and pose a “serious risk” to the Government’s drive to open up the health service to competition.

But managers, who are already rationing surgery for cataracts, hips, knees and tonsils, say they must restrict treatment as the NHS is under orders to make £20 billion of efficiency savings by 2015.

Lord Carter of Coles, chairman of the panel, said: “Commissioners have a difficult job in the current financial climate, but patients’ rights are often being restricted without a valid and visible reason.”

Katherine Murphy, chief executive of the Patients Association, said: “It is outrageous that some primary care trusts are imposing minimum waiting times. The suggestion that it could save money because patients will remove themselves from the list by going private or dying is a callous and cynical manipulation of people’s lives and should not be tolerated.”

Since 2006, NHS patients who need routine elective care have had the right to choose between at least four hospitals, including privately run units. But there have been claims that trusts, the local bodies that pay for treatment, restrict choice and favour some hospitals to balance their books. The panel investigated whether the allegations were true.

It found “many examples of PCTs excessively constraining patients’ ability to choose, and providers’ ability to offer routine elective care services”.

Managers restricted GPs’ ability to refer patients to some hospitals by imposing “caps” on the number a provider would be paid to treat and by imposing minimum waiting times, its report said.

Under government targets, patients should be treated within 18 weeks of referral by a GP. But even when surgeons could see them far sooner, the study found that some trusts made hospitals wait as long as 15 weeks before operating. The tactic forced private hospitals, which were more likely to be able to treat patients quickly, to operate as slowly as overcrowded NHS units in an “unfortunate levelling down”.

Some managers insisted that longer waiting times would lead to overall savings as “experience suggests that if patients wait longer then some will remove themselves from the list”. Interpreting this statement, the panel noted: “We understand that patients will ‘remove themselves from the waiting list’ either by dying or by paying for their own treatment at private-sector providers.”

It said that minimum waiting times should only be used as a “last resort” and told trusts to publish their policies on the home page of their websites.

The panel also found that trusts tended to give elective business to their local NHS hospital, rather than allowing choice, in order to ensure its other services, such as casualty departments, remained financially viable.

The findings come as the NHS is under pressure from increasing demand and tighter budgets. Waiting times have lengthened since last year’s general election and more trusts are increasing the number of procedures of “low clinical value” that they turn down or insisting that patients’ conditions worsen before they are seen.

Labour last week unearthed Treasury figures that show health spending totalled £101.985billion in 2010-11, down from £102.751billion in the last year of Labour, despite David Cameron’s pledge that “the money going into the NHS will actually increase in real terms”. The Tories pointed out that the fall represented the last part of the previous government’s five-year spending plan.

By Christopher Hope Whitehall Editor JAMES MURDOCH faces being recalled to give evidence to MPs after a third former News International executive formally questioned his evidence.

Jonathan Chapman, the company’s former head of corporate and legal affairs, claimed that there were “serious inaccuracies” in statements made to the Commons’ Culture, Media and Sport select committee by Mr Murdoch and Rebekah Brooks, the company’s former chief executive.

In a letter to MPs, Mr Chapman said he was “willing fully to co-operate with the select committee in its investigations in order to ensure that the truth is established”.

Earlier last week, two other former News International executives, the lawyer Tom Crone and Colin Myler, the last editor of the News of the World, also questioned Mr Murdoch’s version of events.

Scotland Yard has also said that it is expanding its inquiry to cover hacking of emails, while the editor of the Rupert Murdoch-owned New York Post asked employees to save any information they had relating to phone hacking or police bribery at the paper.

Glenn Mulcaire, the private investigator who was jailed for snooping on voicemail messages on behalf of the News of the World, issued a statement last week through his lawyers in which he insisted that he had acted “on the instructions of others”.

More health news: Page 12

Hacking scandal: Page 6

Continued from page 1

politicians of playing “a game of chicken” over reaching a deal and claimed the rest of the world had been “kidnapped” by “dangerously irresponsible” American politics. Such was the growing uncertainty in the markets that Moody’s, the credit rating agency, threatened to downgrade Spain last week as the eurozone’s troubles continued.

Private investors have become so nervous that they have put just a 10th of the recent average monthly amount into the stock market. Latest figures for the Investment Management Association showed that the money invested in funds during May was £64million, compared with a monthly average of £650million over the past year. Fund managers said the trend had continued.

Investors also pulled

£60million out of Europe funds and £154million out of US funds in May alone – before the problem in the eurozone had revealed its full extent and long before the US debt crisis. If investors continue to shun the markets, the projected total sales of funds for 2011 will be just £19 billion. Last year, the figure was £23 billion and in 2009 it was £26 billion.

Mr Obama commented: “There are a lot of crises in the world that we can’t always predict or avoid — hurricanes, earthquakes, tornadoes, terrorist attacks. This isn’t one of those crises. The power to solve this is in our hands.”

Sales of gold funds increased 58 per cent two weeks ago, according to Barclays Stockbrokers, and sales of BlackRock’s Gold and General fund increased 33 per cent between the months of June and July.

Rob Fisher, the head of personal investments at Fidelity International, said that even its more active investors were wary of committing to the markets and waiting until there was a clearer outcome in the US and European debt issues.

This clarity may have come by Tuesday, when the US was officially due to run out of money. Mr Obama, the Republican House of Representatives and the Democrat Senate had to make a decision about the US’s $14.3 trillion “debt ceiling” before then or risk default.

Disagreements between Mr Obama and John Boehner, the Speaker of the House of Representatives and the US’s most senior Republican, over spending cuts meant that Congress was failing to reach a decision.

The uncertainty led the price of gold to rise to a new high of $1,630 (£992) an ounce as nervous investors in America sought refuge. Closer to home, the FTSE 100 fell 44 points last Friday to 5,829.

In Europe, Moody’s said that it was reviewing Spain’s credit rating and would probably downgrade it by one level. Shortly after this warning, the Spanish government called a surprise early election for November.

John Chatfeild-Roberts, the chief investment officer for Jupiter Asset Management, said that the developed economies would struggle for “several more years”.

“The whole developed world is struggling with being over-indebted,” he said. “Unfortunately, we think this will go on for quite some time – several years. It can gradually wind down, but we have to wait.”

Business: Pages 33 and 34