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What’s happening to waiting times?

BMJ 2011; 342 doi: (Published 01 March 2011) Cite this as: BMJ 2011;342:d1235
  1. John Appleby, chief economist
  1. 1King’s Fund, London W1G 0AN, UK
  1. j.appleby{at}

The English National Health Service was once notorious for its excessive waiting times. But is it now winning the “war on waiting”, asks John Appleby?

If there was one thing that characterised England’s National Health Service for many people, it was the inordinate time patients waited to get treatment. At its inception in 1948 the NHS inherited a waiting list of nearly half a million. For decades after, it was all downhill—or rather uphill; numbers on lists rose and time spent queuing grew longer. It seemed that waiting was an inevitable rationing response of a system lacking the market’s equilibrating price mechanism. Inevitable, that is, until the alignment of public opinion, money, and political determination at the turn of the century produced a plan of action to deal with excessive waiting.

The plan was more Baldrick than Blackadder in its cunning—more money, successively tougher targets (not known as “P45 …

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