THE NHS may be cancelling more than twice as many operations at short notice than the government has acknowledged.

The figures, disclosed in reports prepared by individual hospital trusts, contradict ministers’ claims that “only” 66,000 operations a year are cancelled.

Instead, the figure is estimated to be at least 132,000.

The “real” cancellation data add to the row caused last week when it emerged that Margaret Dixon, 69, had had an operation to rebuild her shoulder cancelled seven times. Dixon’s case was highlighted by Michael Howard, the Tory leader, to show up what he said were government failings on health.

The pressures on the NHS were highlighted last night when it emerged Great Ormond Street children’s hospital in London had been forced to call off some operations and close up to one fifth of its beds at some points because of a £1.7m deficit for the current financial year.

Dozens of children needing critical care have also been sent to other hospitals because of bed shortages and nursing cuts.

Hospitals have seen costs escalating because of restrictions on doctors’ working hours and increased pay for consultants.

John Reid, the health secretary, said last night the government pledged “fast access with guaranteed times for everyone.” Under plans already announced, hospitals will no longer receive money to pay for operations they fail to carry out.

The discrepancy in the cancellation figures arises because the Department of Health only counts procedures called off within 24 hours of the scheduled operation in its figure of 66,000 cancellations last year.

However, a series of reports have now shown that if operations cancelled earlier are also included, the total figure at least doubles. Hospital managers have been accused of manipulating their figures by ensuring operations are called off ahead of the 24-hour deadline.

Beating this cut-off point means a hospital is not obliged to treat the patient within one month of the cancellation.

The practice of early cancellations has been highlighted by a report on Worcestershire Acute Hospitals NHS Trust, which found it cancelled more operations in the days leading up to an operation than on the day itself. According to a study published last year by the health scrutiny panel of Worcestershire county council, only 856 of the 1,791 operations cancelled in 2003 were called off within 24 hours of the appointment.

Further evidence comes in a report by the National Audit Office, which found in 2000 that Royal Shrewsbury Hospitals NHS Trust was cancelling as many as five operations before the day of admission for every one called off within 24 hours. Early cancellations were widespread in other trusts.

Jonathan Fielden, vice-chairman of the BMA’s consultants’ committee, said: “This is not uncommon. When managers are faced with losing their jobs if they miss a target they will find anyway to get round that target.”

Additional reporting: David Sanderson

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