Assembly Health Minister Jane Hutt yesterday claimed health chiefs were winning the fight to cut hospital waiting times. But many people still face a long, painful wait for their operations, Andy Rutherford reports

FOUR thousand people in Wales were waiting more than 18 months for hospital treatment by the end of July.

That was a fall of 1.7 per cent - or 68 patients - on the June figure, following a drop of more than two per cent during May.

Early signs perhaps, that Assembly Health Minister Jane Hutt's determination to tackle a backlog of 'long waiters', people who have waited 12 or 18 months or more for surgery, is bearing fruit.

But it is also an illustration of why the prospect of NHS patients being sent over the Channel for treatment is a short-term possibility.

Yesterday Ms Hutt promised continued action, saying: "It's not going to happen overnight, but we have the strategy and the investment to ensure that patients in Wales receive the best possible care in the shortest possible time. To this end, I have set specific targets and I fully expect them to be met."

Waiting lists, despite millions of pounds worth of initiatives to meet targets set at various times during the last four years, remain high.

In Wales at the end of March 1997, 67,609 people were waiting for treatment. Four weeks ago, the figure was 67,887.

In the intervening four years and four months, that figure has risen and fallen, as successive attempts have been made to cut it.

By the end of July 2000 more than 80,000 patients were on the treatment list - this fell to 65,500 at the end of March 2001.

Lack of sustainable investment has been a problem, with short-term initiatives to meet targets for cutting waiting lists having driven the system.

The budget of March 2000 offered the prospect of long- term major investment into the National Health Service for the first time in almost 20 years and the government - and the National Assembly - has already committed hundreds of millions of pounds. But change cannot happen overnight.

The small falls in the number of patients waiting more than 18 months for treatment during the past two months may be the start of such a sustained trend.

But many patients still face long waits for surgery - such as hip and knee replacement - that could change their lives for the better.

And for some, the prospect of quicker treatment elsewhere - even abroad - is tempting. Yesterday Newport pensioner James McCarthy told the Argus he would be prepared to go overseas to have a knee operation he has been waiting four years for.

A recent European Court ruling will allow patients to seek an NHS-funded operation abroad if they have endured what the court described as "undue delay".

An Assembly spokesman said treatment as close to home as possible is the preferred option and the Assembly has yet to fully consider the possible implications of the ruling. But patients already travel outside their own health authority areas to other hospitals in Wales or in England for some treatments, notably cardiac surgery and more recently cataract and orthopaedic surgery.

Expanding that principle to take in treatment overseas may be the next step, for however long it takes to bring down waiting times and make "undue delay" a thing of the past.