BMA rejects ministers' claims over A&E waiting

The British Medical Association accused the Government yesterday of misleading the public over waiting times in casualty departments and blamed NHS managers for manipulating the figures.

A survey of 160 accident and emergency consultants by the BMA showed that half rejected government claims that most patients are seen within four hours, and that 24-hour waits had been eliminated. One in five casualties had patients who had waited more than 24 hours for a bed in the week before the survey, and two in five said this was sometimes the case.

The government figures, including a claim that eight out of 10 patients are seen within four hours of attending an A&E department, are set out in its report, Reforming Emergency Care, published last year.

The BMA said the Government had painted an "overly optimistic" picture. Don MacKechnie, chairman of its casualty sub-committee, which published yesterday's survey, said: "I think the Government has published figures submitted to them by NHS managers. How the figures are obtained by managers is for them to say. Undoubtedly there is incredible pressure put on managers to meet the targets."

Mr MacKechnie, head of casualty at Rochdale Infirmary, said a recent survey of managers showed a significant minority were filing inaccurate figures on hospital waiting lists. The NHS chief executive, Nigel Crisp, subsequently published a code of practice and announced that any manager found to have fiddled figures would be sacked.

"I would suggest managers are under pressure to perform ... It's lies, damned lies and statistics," Dr MacKechnie said. "There are only two groups who really know what is going on in A&E – the consultants and nurses who do the work, and the patients."

The BMA report, Waits and Measures: Improving Emergency Care for Today's Patients, surveyed 40 per cent of A&E units in July. It found a quarter of consultants said the situation had improved but more than a third said it had deteriorated in the last year.

The biggest problem was a shortage of beds. Some departments had bought "super trolleys" that fulfilled the definition of a bed to get round the targets for not keeping patients waiting on trolleys. Others had redesignated corridors as wards by putting beds in them and hanging up a sign saying "ward", Mr MacKechnie said.

"You cannot designate something as a ward by putting a bed in it and pulling a curtain round it. It lacks proper privacy and proper facilities."

John Heyworth, president of the British Association for Accident and Emergency Medicine, said: "Too many patients are still waiting far too long in emergency departments throughout the UK."

A Department of Health spokeswoman said: "Three quarters of those who go to an A&E department, who need to be admitted to hospital, get a bed within four hours. Those aren't our figures – they're Audit Commission figures from 2000. By December 2004 all patients will be in and out within four hours ... the old queueing system is being replaced with one where patients are treated as soon as they come in."

The BMA report also says some casualties have genuinely cut waiting times. The Royal London Hospital brought in a scheme in which the first available team member began a patient's treatment and radiologists worked within the department.