The hospital waiting lists system in Scotland needs a complete overhaul, according to an official report.

The Audit Scotland report found that the number of people placed on deferred waiting lists has doubled and that they have less chance of getting speedy treatment.

Health Minister Malcolm Chisholm has indicated that the controversial back-up lists could be scrapped.

But he denied opposition claims that the Scottish Executive has been "caught fiddling the figures".

Robert Black: "Practices should be improved"

The report from the Auditor General for Scotland, Robert Black, said patients on the main waiting list in Scotland fell from 84,521 to 71,965 between 1993 and 2002.

However, it found a large increase in patients on deferred lists, which should only be for those not immediately available for treatment.

The numbers on deferred lists have risen from 13,451 to 25,270 over the past decade.

Although the study found no evidence of foul play in waiting list administration, it criticised inconsistent practices across Scottish NHS trusts.

Hospital trusts

Four acute trusts - Argyll and Clyde, Fife, Lanarkshire and South Glasgow - could not explain why they were not routinely placing all patients on waiting lists.

The study focused on 2,200 patients from 15 acute trusts, which run hospitals, and patients from 13 primary care trusts, which run local doctors' practices.

Mr Black, said better management was needed if waiting times were to be reduced.

The auditor general said that hospital trusts have an incentive to focus on clearing their main list because those patients are covered by guarantees on how long they have to wait.

But he stressed there was no evidence that the figures were deliberately fiddled.

John Swinney: Attacked Labour record

Scottish National Party leader John Swinney has been pursuing this issue since December.

He said the report vindicated his claims.

"The government has been fiddling waiting lists and they have been caught out fiddling waiting lists," he said.

He said deferred waiting list must be abolished and all patients issued with a waiting time guarantee.

Personal reasons

The health minister said he was considering ending deferred lists.

Mr Chisholm said he was "open minded" as to whether deferred lists were replaced with a single list, but added that many people chose to be on the deferred list for personal reasons.

"We believe in a culture of improvement and we want to know what the problems are," he said.

"Part of what is being recommended here is for better information and we support that."