Sturgeon orders investigation into NHS Lothian management

THE Health Secretary has ordered an investigation into the management culture of an NHS board accused of manipulating waiting times figures to meet targets.

Nicola Sturgeon said NHS Lothian betrayed patients by marking them as unavailable to artificially reduce the number in breach of the statutory waiting times guarantees.

An independent report given to Ms Sturgeon yesterday showed the health authority “masked” the true number of patients having to wait longer than they should.

In a statement to Parliament today, she said: “My reaction to this report is one of disappointment and considerable anger.

“Waiting times guarantees matter. Patients value them and staff work hard to deliver them.

“I will not tolerate the manipulation of them.”

Disciplinary proceedings are under way into what could be “serious misconduct”, she said.

The report found the management culture put staff under pressure to find “tactical solutions” to waiting times rather than tackle the root causes.

“That is completely unacceptable. There is no place in any part of the NHS for a management culture of this type,” she added.


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An investigation will be held to “root out” any such practice or culture, she told MSPs.

It emerged in October last year that NHS Lothian had asked patients to go to appointments in England. When they declined, they were not included on a list of patients waiting the target of 18 weeks for treatment.

The new report by professional services firm PWC added: “However, offering patients treatment in England was only one example of the problematic issues with NHS Lothian’s waiting times management.”

In a 10-minute statement, Ms Sturgeon said PWC had detailed completely unacceptable practices.


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She said: “The key finding of the PWC report - which examined the period from April to December 2011 - is that NHS Lothian has been applying periods of unavailability to some patients inappropriately in order to artificially reduce the numbers of patients who would otherwise have been reported as breaching waiting times guarantees.

“This had in the main been done by retrospectively adjusting the patient’s waiting time record.”

She said, however, that the “clear majority” of patients were being treated within the time limit.

Ms Sturgeon added: “It is important to make clear that these unacceptable practices have now ended in Lothian.


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“And indeed the ending of them has resulted in the surfacing of a significant number of patients who have breached their waiting times guarantees.

“The board has put arrangements in place to ensure that these patients are treated as quickly as possible.”

A Scottish Government team has been sent to work with the board to address the problem in the long term.

All other NHS boards have since assured the Health Secretary that they act in line with the regulations.


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However, Ms Sturgeon said each board will now carry out an audit of waiting times management for 2012-13, with the results made public.

She added: “I want people to have confidence in NHS Lothian and in every part of Scotland.

“Patients expect and deserve that the rules that we set out to ensure speedy access to treatment are complied with and I intend to make sure that they are.”

Labour health spokeswoman Jackie Baillie said: “The people of Scotland should be able to trust the Scottish Government statistics on waiting times.


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“This unfortunately suggests they may not be worth the paper they’re written on.

“And some may even suggest that this is the SNP’s hidden waiting list.

“To dispel any such notion, rather than simply an internal audit undertaken by health boards, I ask the Cabinet secretary to request that Audit Scotland undertake a full and thorough review of each and every territorial health board in Scotland to restore confidence in the system.”

Conservative David McLetchie said that as a Lothian MSP, he is “appalled” by the revelations.


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He added: “There is no getting away from the fact that at certain levels within NHS Lothian there has been more concern about the doctoring of statistics than there has about the treatment of patients.”

Mr McLetchie asked: “Can we have any confidence that the heads which should roll will roll?”

Liberal Democrat MSP Alison McInnes said: “There is little point in waiting time guarantees if patients can be cheated in this way.

“NHS Lothian’s comprehensive manipulation of the system is pretty disgraceful.


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“If patients had a right to access information all along the way about their individual pathway then perhaps this couldn’t have happened.”

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