BBC Health Correspondent Alison Holt: "The NHS is permanently overstretched"

However, a survey of NHS managers has found that waiting lists are unlikely to fall as rapidly in coming months as hospitals are struggling to cope with increased demand for services.

The number of people on NHS waiting lists is now 1,162,100 - down 150,621 from the high point in April 1998.

The fall, the seventh in succession, was mirrored by a reduction in the number of people waiting for hospital treatment for more than 12 months.

This figure fell by 4,600 in November - bringing the total drop to more than 16,000 since June.

Frank Dobson: admitted that waiting lists might go back up

Health Secretary Frank Dobson said: "This latest achievement by NHS staff is proof yet again of their skill and their commitment to delivering what matters most to patients - quicker access to treatment and shorter NHS waiting lists.

"All this is against the background of more non-emergency cases being treated than ever before, more emergency cases being treated than ever before, and more patients being seen than ever before.

"That is a massive effort across the board to deliver success."

However, Mr Dobson admitted that waiting lists might begin to rise again because of the surge of cases going into accident and emergency wards, especially with the flu crisis now sweeping the country.

"These figures cover the period up until the end of November," Mr Dobson said.

"Understandably and quite rightly, since then a large part of the efforts of the staff have been devoted to dealing with serious winter pressures that we are experiencing."

Shadow health secretary Ann Widdecombe said: "Frank Dobson's fantasy waiting list fall will come as no comfort at all to the hundreds of patients forced to wait in corridors on trolleys for treatment nor to the relatives of people whose bodies were stored in a refrigerated lorry because the hospital mortuary was full.

"Mr Dobson's complacent attitude towards our health service is shown once again by his boasts that waiting lists have fallen by `record levels'.

"It all looks a bit shallow considering that the number of people waiting over 12 months for treatment has doubled under this Government."

Dr Evan Harris: "Government has distorted priorities"

Liberal Democrat health spokesman Evan Harris said the government's "obsession" with reducing waiting lists was leading to doctors' clinical priorities becoming "distorted".

He said: "We have already seen, in the emergency winter crisis, effects of this as hospitals have been forced to keep open beds for waiting list initiative patients while emergency admissions wait on trolleys in accident and emergency departments.

"While the numbers waiting for an operation having seen a specialist have come down, the number waiting to even see a specialist have shot up."

NHS bosses warning

The NHS Confederation, which represents NHS trusts and health authorities, said the fall in waiting list figures showed that the NHS could deliver given proper investment.

Releasing the results of a new survey, however the confederation warned that waiting lists are unlikely to fall as fast in December and January because hospitals are focused on managing the winter emergency pressures.

The initial survey findings show that:

• Most trusts (73%) think that emergency admissions are compromising their trust's ability to achieve waiting list targets;
• The majority are experiencing a rise in emergency admissions (97%); a rise in bed occupancy (77%) and unacceptable trolley waits for some patients (91%);
• Eight-five per cent believe the current experience of winter pressures is worse than last year. The cause is given to be predominately the normal rise in activity over winter plus the increase in flu cases.

Stephen Thornton, chief executive of the NHS Confederation, said: "The public and politicians expect the NHS to run efficiently at full capacity, so when hospitals face a surge in activity priorities must be shifted.

Stephen Thornton said operations are being cancelled to deal with emergencies

"It is clear that operations are being cancelled to deal with emergency admissions, and so realistically there is a high chance that waiting list targets will be affected.

"Trusts are not inflexibly sticking to their waiting list targets at the expense of patients with emergency care needs. The NHS delivers what is needed at the time."

The Confederation cautioned against talk of a crisis. Most Trusts had not been forced to divert emergency admissions (71%) or close to emergency admissions (84%) at any time.

The main constraints on the ability of trusts to accept and admit emergency cases were: bed availability, lack of nursing staffing, response of social services, staff illness and absenteeism, primary care provision and facilities to assess emergency admissions.