Nigel Crisp was 'shocked' by the findings

Promising clearer guidelines he said: "We're introducing a management code of conduct so that if somebody is adjudged to have broken the management code of conduct in one setting as a manager in the NHS, they should not be employed as a manager anywhere else in the NHS."

But Mr Crisp said the key to patient satisfaction would come from better whistle-blowing systems inside the NHS, an independent inspection system and the publication of waiting list information on the internet.

"I think giving patients information is probably the single biggest safeguard we can bring in," he said.

'Shocking'

It's the lowest form of cynicism for managers to protect their own backs and their own jobs at the risk of extending and aggravating the suffering of patients waiting for treatment

Alan Williams

Mr Crisp told MPs he found the report's findings shocking and that very serious issues had been raised, damaging the reputation of honest, hardworking NHS managers.

He said very important lessons had been learned from the NAO report and patients should be able to expect better from NHS management.

MP's on the Committee expressed anger at cases of NHS managers who were found manipulating waiting list figures and then allowed to resign with compensation packages.

Alan Williams, Labour MP for Swansea West, said: "It's the lowest form of cynicism for managers to protect their own backs and their own jobs at the risk of extending and aggravating the suffering of patients waiting for treatment."

Pressure

Pressure is no excuse for doing these sorts of things

Nigel Crisp

Mr Crisp denied claims, backed by Conservative leader Iain Duncan Smith, that the problems were caused because waiting list targets put too much pressure on managers.

He said: "There is no evidence that it was pressure. If it was, everybody would be doing it.

"Pressure is no excuse for doing these sorts of things."

Mr Crisp said he did not believe any of the 6,000 patients affected had died as a result, although he was asking the trusts involved to establish whether any had suffered.

Whether compensation should be paid to any of them was a matter for the trusts, he said.

'Organisational failure'

The National Audit Office report said waiting lists were manipulated, on purpose or as a result of "organisational failure", so patients did not exceed the government's 18 month limit.

At the Surrey and Sussex Healthcare Trust it is claimed patients were asked when they would be on holiday and then deliberately offered appointments at those times.

Elsewhere it is alleged patient records were systematically amended and patients removed from waiting lists.

The NAO report said that while some patients may have been unaffected by the actions, others "may have deteriorated during the longer wait".

'Spot check'

Guilty trusts

Barts and the London Guy's and St Thomas's, London Plymouth General Hospital Redbridge Health Care Salford Royal South Warwickshire General Stoke Mandeville Surrey and Sussex Healthcare University College London

Following the report Mr Crisp said trusts will face rigorous checks to prevent further fiddles.

He said: "We're putting in place spot check arrangements for trusts, and we're also making sure that we tighten up our procedures to deal properly with it when it does happen."

The checks are set to be carried out by the Audit Commission from later this year, according to the Department of Health.

Waiting lists

On Friday it was announced the total number of patients waiting to be admitted to NHS hospitals in England rose by 10,100 (1%) in the 12 months to November 2001.

The number of English residents waiting more than one year fell to 33,000, some 14,800 (31%) lower than November 2000.

The number of patients who had been waiting for longer than 18 months was 23.