Compensation may have to be paid to many people affected by widespread waiting list fiddling at NHS hospitals, says a new report.

The Commons Public Accounts Committee believes that in some cases longer waits may have "prolonged the suffering" of patients, or even worsened their condition.

At least one patient is already thought to be taking legal action.

Officials are worried they are going to get their knuckles rapped and this is what happens

Edward Leigh

Waiting list fiddles have been uncovered at 10 hospitals in England.

Many involved taking patients off waiting lists for no reason to make the numbers look smaller, or concealing those waiting more than the government's 15-month limit.

Holiday hell

In one case, a hospital routinely booked operations in weeks on which patients were known to be on holiday - giving it an excuse to suspend them from the list when they could not attend.

Waiting list "fiddle" hospitals

Barts and the London Guys and St Thomas' Plymouth Hospitals Redbridge Healthcare Salford Royal South Warwickshire Stoke Mandeville Surrey and Sussex Healthcare University College Hospital, London Royal United Hospital, Bath

The report strongly criticises the way the NHS responded to the scandal - often failing to root out those responsible, or allowing them to resign with compensation payments or a new job elsewhere in the NHS.

In all, severance agreements costing the taxpayer �260,000 were agreed, many of which included "gagging clauses" already outlawed in the NHS.

Conservative MP Edward Leigh, chairman of the Public Accounts Committee, said deliberate manipulation of waiting lists undermines public confidence in the NHS.

Speaking on BBC Radio 4's Today programme, he said: "There is more and more pressure being put on officials, they are worried they are going to get their knuckles rapped and this is what happens."

Compromise

The government has introduced a new "code of conduct" for NHS managers in the wake of the scandals coming to light.

It forbids any manipulation of waiting lists in order to meet ambitious government targets.

In any future cases where we discover issues of this sort we will deal with them very firmly and very fast

Nigel Crisp, NHS chief executive

Nigel Crisp, chief executive of the NHS, said an "exhaustive" survey revealed manipulation of figures affected 6,000 patients - out of around 6m the NHS treats.

He admitted that in some cases trusts had struck compromise deals with managers found to be manipulating the lists.

But he said this had not happend in the last year, and would never happen again.

He said: "In any future cases where we discover issues of this sort we will deal with them very firmly and very fast and make sure that we have safeguards in place to look after the people involved."

Ministers say that the Audit Commission will in future check figures submitted by hospital trusts.

The NAO suspects that there may be more hospitals which have managed to get away with fiddling their figures.

It calls for the government to take a fresh look at any in which more than 10% of patients are suspended from the main waiting list, and have more than 2% waiting for more than a year.

There are currently 13 trusts which meet these criteria.

'Indefensible'

The NHS Confederation, which represents managers in the health service, said that it was "saddened" by cases in which doctors' clinical priorities were distorted by the pressure to keep waiting lists down.

Its chief executive Gill Morgan said: "We also take seriously the very small number of cases of inappropriate adjustments to waiting lists.

"These cases are an indefensible breach of the new code of conduct for NHS Managers which we have been jointly developing with the Department of Health."

For the Tories, Shadow Health Secretary Dr Liam Fox said: "The NHS is being crippled by a combination of ministerial interference and political incompetence."