James Strachan chairman of the commission qualified this claim yesterday when he said some patients might have waited a

James Strachan, chairman of the commission, qualified this claim yesterday when he said some patients might have waited “a couple of months longer than they should”.In South Manchester, which conducted its own review after being alerted to the problem by the Audit Commission, investigators found there had been systematic fiddling of the figures since 1996. It concluded that over a five-year period, 261 patients who had waited longer than the 18-month government maximum had not been declared. If their cases had been properly recorded they would have been offered earlier treatment elsewhere to bring them within the permitted maximum treatment time.The South Manchester report pins responsibility for the scam on the former chief executive Jane Herbert and her former deputy Chris Povah. Ms Herbert resigned last week from her new post as chief executive of Bedfordshire and Hertfordshire Strategic Health Authority; Mr Povah has been suspended from his post as chief executive of East Cheshire Hospitals NHS Trust. Andrew Whitely, the finance director who resigned last year, was also described as peripherally involved, as was an unnamed more junior staff member.Two other trusts were named by the Audit Commission as having deliberately fiddled their figures.

Scarborough and North East Yorkshire suspended three directors – Liz Parker, Martin Hay and Jim Brace – before Christmas and set up an inquiry.East and North Hertfordshire Trust suspended Simon Meddick, director of planning, in November and an external review is under way.NHS trusts have been under intense pressure to meet waiting list targets, which are due to be reduced to a maximum of six months by 2005.Sir Nigel said that all trusts identified as having problems by the Audit Commission would report back by the end of this month, and all trusts nationally would review their systems for recording waiting times by the end of June.. Foundation trusts will be allowed to raise their own finance from capital markets, set pay rates and will be free of interference from the Government.Gordon Brown, the Chancellor, has made plain his reservations about the idea and more than 100 MPs signed a Commons motion opposing the plans, fearing they would create a “two-tier” health service.But Mr Milburn said he had “never, ever” intended that foundation status would be granted only to half a dozen elite institutions. Instead, there would be annual waves of foundation hospitals created until all 300 NHS trusts in England had achieved the three-star rating needed for the new status.The Department of Health published a list yesterday of 32 high-performing trusts that had expressed an interest in the plans and said a shortlist would be announced in the autumn.Mr Milburn said a Bill would be introduced to the Commons in the next four weeks and would have its second reading in the Commons by May. The first wave of foundation hospitals would be in place by April 2004 and a second wave would follow a year later, he said.In a substantial extension of the policy, Mr Milburn will also write this week to all two-star rated NHS trusts asking them to begin preparations to apply for foundation status.Mr Milburn refused to rule out giving similar freedom to primary care trusts, which plan and fund GPs and other services. Speaking to the Commons Health Select Committee, he revealed that he expected all hospitals to become foundation hospitals by 2007 or 2008.”I don’t see any reason why we shouldn’t be able to achieve that,” he said.

“This is not just for a few, it is for everybody.”Mr Milburn also reassured MPs that any surplus reported by foundation trusts could be used to boost primary care in their locality. “MPs worry [that] their local hospital, which they are very attached to … is somehow going to be disadvantaged What I am saying to you is that is not the case,” he said.. In any family with children at school, the chances of someone contracting a tummy bug run fairly high. But when the dreaded lurgy strikes any of our three children, it is not only the afflicted one we have to nurse all night, but also the one with emetophobia – a chronic fear of being sick.

The symptoms of her fear are often far worse than the reality of the illness itself. And the irony is that the daughter with the phobia knows this. “I tell myself that, but it doesn’t make any difference, I still feel panicky and awful if I know anyone near me has a tummy bug.”This is typical of phobias. Phobias are irrational, they do not have any regard for statistical or anecdotal evidence and no amount of reasoning on the part of the sufferer or reassurance from others can help to shift their distressing symptoms Polly’s symptoms are palpable She does not have to describe them. She comes out in a cold sweat, she goes as white as a sheet and she is unable to lie down, for somehow she associates this with throwing up.The last time her little brother had a tummy upset, Polly’s symptoms persisted long after his were over, affecting her appetite, her ability to concentrate, and making her life at school miserable.