ody of consultant surgeons, the question arises of how consultant surgeons are able to manipulate waiting lists.
Yates (1995) describes five 'coincidences' that are worth taking as a starting point to this question.
"The poor are more prone to illness and early death, and it is the poor who have to wait longest for treatment
The regions that have the most private beds are those that have the worst waiting lists
The specialities that have the longest waiting times are the ones that have the highest earnings from private practice
The conditions that involve the longest wait on NHS lists appear to be the mainstay of private sector workload
The surgeons who work in the private sector are thought to have the long NHS waiting lists."
Leaving the first 'coincidence' aside for the moment, the latter four are suggestive that surgeons not only have a vested financial interest in retaining long waiting lists, but also have many mechanisms with which to achieve this aim.
Of particular relevance is the fact that many surgeons working in the NHS are the very same surgeons working in the private sector (Hammond, 1999, Powell, 1997, and Yates, 1995), indicating that as no-one can be in two places at the same time, the more private work a surgeon undertakes, the less NHS work they can do.
Added to this is the control that surgeons have over their waiting lists in terms of who is allowed on and who isn't as well as some control over how frequently operations are actually performed. In particular, Yates (1995) found that there is a significant variation in the number of operations carried out by different NHS consultants in the same speciality despite having a similar case mix. Implying that either there is a large discrepancy between the resources available to different surgeons or that individual surgeons are working a lot harder for the NHS than others.
This could lead to the conclusion that some NHS surgeons are deliberately ma...