Doctor, when can I have my operation?”

“Well, my dear, in a few weeks I suppose.” I was learning fast.

I walked into my first UK consultant job from a similar job in France 13 years ago. At first my patients were easy to please, because there was no waiting list in my orthopaedic firm. But I can take no credit for this, because mine was a newly created job, and at first I had to steal patients from colleagues to have something to do. Otherwise, however, waiting lists were omnipresent and, apparently, an unavoidable fact of life. Still, how unavoidable could they be? I had had no waiting list in France. In fact I had to translate from English to explain to my French wife what it meant: “Liste d'attente.” She knew you could get stuck on a liste d'attente while desperately trying to reach a representative of the French bureaucracy over the phone, but a surgical liste d'attente? She was horrified.

I was determined not to allow a waiting list to form. I thought, “I'll show them how I can organise an efficient service and get operations done at the same rate as I see patients in clinic.” How naive I was. Within two years I was operating on people who had been on the list for a …