NHS '˜legal' waiting time guarantee may undermine care

Scotland's former chief medical officer has suggested that enshrining a flagship NHS waiting time guarantee in law was a mistake.

Scotlands former chief medical officer has suggested that enshrining a flagship NHS waiting time guarantee in law was a mistake. Picture: BEN STANSALL/AFP/Getty Images

Sir Harry Burns also called for a rethink on the 18-week referral to treatment (RTT) guarantee for patients with cancer as it could mean patients don’t get the best treatment.

He was speaking as he published a report into the use of targets and indicators in Scotland. It calls for broader approach to healthcare and understanding what makes people unwell in the first place, rather than just focusing on narrow targets.

The Scottish Government introduced the legally binding right to get operations within 12 weeks as part of the Patient Rights Act in 2011. But it has been breached thousands of times over years, as hospitals fail to meet targets.

It was put to the former chief medical officer yesterday that he seem “critical” of this being put into law. He replied: “Well, yes, because clinical practice isn’t like that.

“There are always circumstances, if someone is coming up to 11 week and five days and they’re due to come in on the sixth day and they’ve got a cold or something like that. You breach the target. And OK, you can have ways of taking them off, but it’s just not the way clinical practice works.”

Scotland is the only country in the world which has an 18-week referral to treatment guarantee for cancer care, alongside the 12 week legal maximum wait for treatment after being referred. Sir Harry’s report says the former should be dropped as it may “alter clinical decision making” as doctors are too keen to see the patients meet targets instead of being clear about the right course of treatment.

Sir Harry said “complex investigations” may be needed, while patients may need to time to think about their treatment. He backed the retention of the 12-week limit.

He also conceded that targets have had a positive impact in speeding up NHS treatment and should be retained, particularly in areas like A&E.

The British Medical Association had called for the legally binding guarantee to be removed from the Patient Rights Bill.

Dr Peter Bennie, chair of BMA Scotland, said: “We have consistently stated that we do not believe that any political guarantee regarding specific waiting times has a place in law.”