Waiting lists in the post-review NHS.

Waiting lists for hospital inpatient treatment have existed since the foundation of the NHS. There have been many theories put forward to explain them and a wide range of proposals have been advanced to reduce or eliminate them. The effect of the recent changes in the NHS, coupled with the renewed political focus on waiting lists, is explored. It is concluded that access to waiting lists may be restricted, either by explicit rationing or as a result of contractual specifications. Further, the introduction of GP Fundholding, together with the purchaser-provider split, could result in a two-tier service, at least for non-urgent patients. These conclusions are illustrated by the findings from a simple simulation model.