Image caption Insisting patients wait a certain length of time before treatment has been used as a way to save money

NHS managers in England abuse the system by making patients wait longer for care, the health secretary says.

Andrew Lansley was speaking out after a competition watchdog criticised the way non-emergency operations, such as knee and hip replacements, were being run.

The Co-operation and Competition Panel said some primary care trusts had introduced minimum waiting times to save money and level-down performance.

It said some patients were forced to go private or died before they got care.

But managers reacted angrily to the claims.

David Stout, director of the Primary Care Trust Network, said: "Making claims without evidence that patients are dying as a result of longer waiting lists will cause unnecessary public anxiety and alarm.

"Commissioners take very seriously their role to ensure that patient health is not put at risk waiting for the care they need."

The panel was unable to say how many places were adopting such practices and the report did not name any individual trusts.

It is also unclear what patients were dying from as the treatment they were waiting for was not life-saving care.

But the report cited an anonymous example where one trust was insisting patients wait at least 15 weeks for treatment. Such a time frame is within the 18-week limit, but many hospitals can see patients more quickly than that.

'Delay treatment'

Mr Lansley said the findings justified his reform programme, which aims to put doctors in charge of decision-making.

"This is exactly why we need to put patients' interests first," he said.

Too many PCTs have been operating in a cynical environment where they can game the system Andrew Lansley, Health Secretary

"Too many PCTs have been operating in a cynical environment where they can game the system - and in which political targets, particularly the maximum 18 week waiting time target, are used to actually delay treatment.

"When GPs, specialist doctors and nurses are making the decisions, as they will under our plans, they will plan care on the basis of the clinical needs of patients and their right to access the best service, including the least possible waiting time."

The effect of minimum waiting times is two-fold. Firstly, it can be used to save money if treatment is knocked into the next financial year.

And private health firms seeing NHS patients have argued it erodes their competitive advantage. Since 2006 patients have had a right to choose where they go for treatment including private hospitals given official approval.

They tend to be able to see people more quickly than NHS centres and therefore making patients wait longer negates one of their selling points, some firms have argued.

The CCP report also looked at a whole host of other anti-competitive and patient unfriendly practices being employed by NHS trusts.

As well as introducing minimum waiting times, these included giving local NHS hospitals guaranteed levels of treatment, rationing the range of treatments private hospitals could provide to the NHS and capping the number of patients that could go outside the local area.

PCTs had argued the measures were needed to protect local hospitals.