HOSPITALS have been ordered to delay operations and remove patients from waiting lists in order to save money, The Times has learnt.

The move comes a day after Patricia Hewitt, the Health Secretary, admitted that the NHS was more than half a billion pounds in the red.

A letter seen by The Times reveals that a group of London hospitals has been told by NHS managers to postpone surgery for as long as possible in order to cut the trust’s debt. Other hospitals are telling patients that they are no longer eligible for operations in order to make savings.

Harrow Primary Care Trust, which is facing a deficit of £8-£12 million, has asked the hospitals treating its patients to do “the minimum required” to meet national targets. In the leaked letter, Ken Walton, chairman of the trust’s professional executive committee, tells GPs: “This means patients sent for outpatient appointments will only be seen at 10-13 weeks (national target 13 weeks) and elective surgery will be delayed until the sixth month (national target six months).”

It means that the maximum wait of six months promised by the Department of Health will become the minimum. However, the delays will enable the trust to postpone paying for operations, saving it money this financial year.

Dr Walton’s letter also calls on GPs to make fewer emergency referrals and to avoid using the booking centre for the one-stop hernia clinic.

Instead, he says, GPs should send referrals directly toRaj Bhutiani, the lead consultant. “Raj has agreed to hold referrals until April 2006 so he can meet the six-month target and not breach the 13-week target,” the letter explains.

Yesterday the trust defended its policy. “Harrow PCT is taking action to control its expenditure that will not affect the quality of care given to its patients,” it said in a statement.

It had agreed “activity levels” with local hospitals that would ensure national targets were adhered to. “All patients in Harrow will be seen within national targets,” the statement added.

The Department of Health declined to comment. “This is an operational issue for the local NHS,” a spokeswoman said, adding: “Investment and reform are working. The waiting list is at a record low.”

But Michael Summers, chairman of the Patients Association, said: “It’s not right. Patients are in pain and they need operations. Now they are going to have to wait for the maximum length of time to get them.”

Andrew Lansley, the Shadow Health Secretary, said: “The Government denies deficits are affecting patient care, yet as a direct result of deficits, patients are being pushed to the limit of targets. Delaying treatment will not solve the deficit problem.”

Other NHS trusts are saving money by removing patients from waiting lists, a policy condemned yesterday by doctors. Patients who believed that they were waiting for operations are being summoned to see a doctor to be told that under new rules they no longer qualify.

Others are having referrals to consultants barred by special committees who are removing patients from waiting lists. Dr Paul Miller, chairman of the British Medical Association’s consultants committee, said the practice was “outrageous”.

In Oxfordshire, letters were sent to 249 hernia patients and 114 varicose vein patients telling them that they may no longer be eligible for operations. The reason given was that the county’s NHS priorities forum had ruled that they no longer “fulfilled clinical criteria”.

One patient waiting for a hernia operation in Oxford, Patricia Lloyd, was told she could go private or wait until her hernia got worse and justified emergency admission. Thames Valley Strategic Health Authority is £34 million in debt.

In Fulham, southwest London, the local PCT believes that it can save £695,000 by cancelling referrals made by one consultant to another. Again the Department of Health declined to comment. “These issues are local and have nothing to do with central decision-making” a spokeswoman said.

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