Outpatient waiting lists for the early winter months have fallen for the first time in three years. This is despite an annual first attendances rise of 2.2% to 11.8 million.This speeding up of the outpatient system is the first sign that the hard hitting report of the Treasury’s Public Services Productivity Panel published last year has diagnosed the problems and prescribed practical solutions. The Review Team found archaic systems, many dating back to the 1950s. They also found wide variations in outpatient performance across the NHS. This was the first time there had been a major emphasis on reducing outpatient waiting lists.

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The torrent of area based initiatives such as health and education action zones has produced a co-ordination nightmare. Local authorities, with a responsibility for community leadership are suffering from the bureaucratic burden of initiatives conceived and managed separately by individual central Government Departments. The Performance and Innovation Unit in its report ‘Reaching Out: The role of Central Government At Regional and Local Level’ paints a depressing picture of non joined- up government.The Unit’s Review Team found initiatives that affect the same people, such as children, are run separately and not linked in any way. They also found that the number and extent of narrowly focused plans required by central Government from local authorities is inhibiting their ability to take joined-up co-ordinated action.

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