FactCheck targets NHS waiting times
The claim
“Waiting times are rising”
Ed Miliband MP, Prime Minister’s Questions, May 11, 2011
Cathy Newman checks it out
Ever since Tony Blair declared in 1997 there was a fortnight to save the NHS, Labour has won successive elections by convincing the public the Conservatives can’t be trusted to run the health service.
Having lost ground to the Tories on this in the run up to last year’s general election, Labour now feels the tide is turning in its favour again.
The botched NHS reforms announced by David Cameron have given Labour a chance to regain the initiative.
So it was no surprise to hear Ed Miliband today lay into the Prime Minister over rising waiting times.
FactCheck found he’d slipped up last month, so has he learnt his lesson?
The analysis
David Cameron demanded an apology from the opposition leader today for misleading the Commons with the claim that NHS waiting times have risen month on month.
As FactCheck found a fortnight ago, Mr Cameron’s figures were right. From January to February, the median wait (the time spent waiting by 50 per cent of patients on waiting lists) for non-admitted patients – or ‘outpatients’ – dropped from 4.8 weeks to 3.5 weeks. For admitted patients the median wait also dropped from 9.1 to 9 weeks month-on-month.
While Mr Miliband was careful not to repeat his slip up, temperatures rose as he refused to back down. “No Mr Speaker, waiting times are rising,” he said.
So who’s right?
Well, the coalition has changed the goal posts.
Mr Miliband is still quoting the old Labour 18 week target; while the coalition looks at the median wait across the board.
The Labour government’s target was to make sure 90 per cent of patients were treated within 18 weeks of referral to their hospital from their GP.
But this was scrapped by the coalition last June – along with other carrot and stick targets that they said had “no clinical justification”.
So if we stick with the coalition preferred measure of the median wait, here are some comparables provided by the King’s Fund:
December 2009 8 weeks December 2010 8.2 weeks
January 2010 9.2 weeks January 2011 9.5 weeks
February 2010 9.5 weeks February 2011 9.4 weeks
(DoH points out that the King’s Fund does not take account of patients who decline two offers of admission, to allow them to go on holiday for example. But the difference is so small as to be insignificant).
Andrew Lansley has been chided for following George Osborne’s example in “blaming the snow”, but these figures prove he has a point. The caveat with looking at either monthly or year-on-year figures, is that they are hugely seasonal and weather-dependent.
John Appleby from the King’s Fund agrees that quoting month-on-month figures is somewhat futile. “There are very strong seasonal trends,” he told FactCheck. “Over the year waiting times have gone up and they’ve gone down.”
But overall, Mr Appleby says there is a “very slight upward trend” in the median figures.
Meanwhile by Labour’s definition – their old target was missed in February. Based on DoH statistics, 89 per cent of patients were seen within 18 weeks of referral in February 2011. That’s down from 91.9 per cent in February 2010.
Mr Appleby said in this instance there is definitely an upward trend.
Cathy Newman’s verdict
Both David Cameron and Ed Miliband are not being wholly straight with the public.
Some months, for example in the winter, there are more people waiting for operations than others, so using month on month figures as David Cameron did is a bit misleading.
Then again, by looking only at those who are waiting more than 18 weeks for treatment, the Labour leader is using a target which has been scrapped by the coalition government. So that’s not the best measure either.
FactCheck’s preferred figures – comparing one month this year with the same month last year – come from the King’s Fund. Those show a slight upward trend in waiting times.
Although it’s not clear enough to be conclusive yet, in a few months’ time David Cameron may well find it harder to defend his stewardship of the NHS.
The analysis by Emma Thelwell
There are 10 comments on this post
So the fact is that your analysis shows that your preferred figures (from the King’s Fund) “show a slight upward trend in waiting times”.
So why not just cut to the chase: Miliband was right today when he said “waiting times are rising”.
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Seems to me to be a problem of definition (and this article seems to not understand the definition of median waiting time – this is the time that half of patients have to wait longer than while half are seen more quickly than). Cameron’s def allows for a greater likelihood that you will be waiting a very long time than does the “scrapped” 90%-within-18-weeks target. Whether that is clinically justified misses the point that an increasing chance that you might have to wait a very long time is not what patients would prefer (ah, patient choice eh?).
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You might want to fact check your own definition of median there…
The median is the middle value in a data set, therefore it is incorrect to claim that the median wait is “…the time spent waiting by 50 per cent of patients on waiting lists”.
Assuming the *figures* are right, it would be correct to claim that 50% of those patients sampled, waited NO LONGER than 3.5 weeks. Clearly they didn’t all wait 3.5 weeks, there would presumably have been some variation in the waiting times.
This may seem pedantic but I think it’s an important clarification. If you want to maintain the credibility of this service (one which I think is widely valued), then I also think it’s important to get these things right.
Keep up the great work
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Ah well in for a penny, in for a pound
These supposed facts are based on a false mulitfold premise.They are not to be trusted. Targets , targets , targets, misconstrued to make sure the patients fit the figures and figures which don’t represent the patients.What is more staff are punished for voicing these points.The private sector will not improve this as the top people are usually the product of ‘private’
To argue this point of those more and more ‘made up ‘ figures, further made up so called evidence will be put forward . I don’t believe any of it. As patient movement is monitored in hospitals …the real business is patient contact and the variety of problems to meet resource..There is no point in putting out waiting times as criteria for a quality NHS. With proper management, the staff would be allowed to treat the patients effectivly and therefore readmission would be reduced and waiting times lessened.
If executives and managers would stop kicking staff and create an atmosphere of caring about their fellow human beings then this would filter down to bedside care.
We have the wrong people in leading positions and that is the top and bottom of it.
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A few points:
1) The 18 week target has not been scrapped; it lives on in the NHS Constitution and regulations, and in NHS contracts, and is still “managed to” by hospitals.
2) It’s a bad idea to choose waiting time measures that count only those patients lucky enough to be treated; for the true picture you should look instead at those still waiting (the so-called “incomplete pathways”).
3) The median is a poor measure of routine waiting times because it is heavily affected by urgent patients (who are treated quickly regardless of routine waits). Better to use the 90th or 95th centile as a measure of routine waits.
4) Even if the government does stop using a measure, that doesn’t automatically make it invalid.
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The only statistic I accept these days is that 100 per cent of politicians are trying to pull the wool over our eyes in some way.
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Clinical justification is important. Are patients with more serious conditions being seen more quickly nowthan last year?
Statistics can be confusing. Perhaps we should consider a correlation between the winter waiting times and the snow conditions then perhaps a more accurate picture would emerge.
If a patient chooses to wait for a particular hospital or doctor then surely these figures should not be included.
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Barbara , now you are talking prioritorisation which is incalcuble , even if categorised it depends upon individual / practitioner expertise.
I agree stats are confusing and are misused to represent the things we hope they were not intended to .
AS Rob Findley points out it is the unseen , the unmeasured , the out of the category which causes confusion BUT surely that is the problem with attempting to categorise in the first place.
It is surely logical/ common sense to assume that if waiting times are increasing and beds are not available then there is too much work for any one place to handle. As usual problems are being measured too far down the line of reasoning. Symptomatic measurements will only work in a temporary situation . Any diagnostician will enlighten managers to the fact that if the route cause is not treated then similar presentations will be repeated.
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Of course waiting times are rising! After months of waiting first I was finally put on an 11-week-waiting list for the regional pain clinic. Instead of 11 weeks I had to wait 16 weeks. People who are as recent as 3 weeks ago being put on the same list have already been given a waiting time of 16 weeks. As I only just finished the course in pain management, I had a chance to talk to the “doers” and not to the ones making this list. The medical personal is rather wondering whenever they actually see these patients and confirmed that it will not be anywhere near the 16-week-time period!!!!
Other NHS organisations skip waiting lists all together, such as for wheelchair service. Instead they just do not assess every persons wheelchair needs (just take what you given, springs to mind) without any care about the consequences for the users and their enviroment.
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