In a case that highlights the crisis in diagnostic tests, King’s College Hospital, London, warned Rachel King that, because of “heavy demand”, the MRI scan that her consultant had sought could be delayed for 80 weeks.

But a handwritten note at the end of the letter gave a telephone number for the hospital’s “self-pay” private clinic, where she could have the procedure in two weeks for £983.

Ms King’s case is the starkest example yet of widespread delays in diagnostic tests across the health service. One in five trusts has waiting times of more than a year for MRI scans, and two in five have waits of more than six months.

A quarter of trusts said that 25 per cent or more of their scanning capacity was not used but lack of staff and resources prevent increased usage.

To cut the backlog, the Department of Health has signed a £90 million contract with Alliance Medical Ltd to provide mobile MRI scanners. The contract has proved controversial, but both AML and the department claim it is now working well and cutting waiting times.

Ms King, 32, from Erith, Kent, was knocked down by a car in January. She suffered a broken collarbone, five broken ribs, a shoulder blade broken in three places and head injuries. She was in hospital for 17 days. After she suffered dizzy spells and reduced vision, her consultant referred her for an MRI scan. She said that she was appalled to receive the letter from King’s, saying that, because of “heavy demand”, the scan would be delayed.

What added insult to injury was the handwritten note on the bottom, which read: “If you want to go privately call 0845 6080991 for prices.”

When she did, the telephone was answered by King’s College Self Pay, who said that the cost of such a scan was £983, and she could have the procedure in a couple of weeks.

“It’s insulting” she said. “I was absolutely distraught. I need reassurance that the damage isn’t permanent. All I want is to know if it is going to get better.

“I still have falls, and I can’t return to work or drive. I’ve never signed on the dole in my life but I have had to now.”

King’s College Hospital said in a statement that it recognised that an 80-week wait for scans was unacceptable. It had recently received funds to expand its services, with the aim of getting waiting times down to 26 weeks by next March.

Patients identified as clinically urgent by referring doctors would be seen sooner, the statement said. It added that the handwritten note had been included because Ms King had discussed with her consultant the possibility of going private.

“It is not considered best practice to have handwritten additions to letters and internal processes will be reviewed in the light of this letter,” it said.

Steve Webb, the Liberal Democrat Shadow Health Secretary, said: “It is simply appalling that while ministers crow about the drop in treatment waiting times, there are still thousands of people languishing for months, or even years, on hidden waiting lists.

“To have to wait 80 weeks just to get a diagnosis before you end up on the official waiting list figures is just simply not good enough.

“The NHS needs radical reform to ensure that scanners are used more efficiently, at evenings and weekends, and to cut these long waits.”

Andrew Lansley, the Shadow Health Secretary, said: “The Government talks about waiting times coming down but people are waiting far too long for diagnostics.

“There is increased MRI capacity but not enough staff in the NHS to keep them operating longer hours.”

Lord Warner, the Health Minister, said that no hospital should make patients feel pressured into pursuing private treatment. “It would be completely unacceptable for any hospital to ignore their obligations to provide speedy access to NHS treatment,” he said.

“Instances such as this demonstrate why the Government is right to continue to take urgent action to expand capacity in the NHS. By 2008 nobody will wait longer than 18 weeks from GP appointment to treatment.”

Other cases have illustrated similar problems:

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