While getting rather bored in London, I glanced through some old emails of mine and found this to friends of a trip to Karachi, in Pakistan, dated 16 May 2000. So i publish it here for the sake of amusement> it shows even when you discover almost nothing, the act of searching can be quite interesting.

It was the machine gun that rather betrayed his profession.  It was hanging from his shoulder down to his knees and he strode into my room at the Sheraton. Quite disconcertingly, he was also carrying a bouquet of roses and lilies. The note attached said: “With best wishes from Mr Shakeel”.

For those not familiar with Asian criminals, Chota Shakeel is the brother of what Indian papers like to call the “dreaded” or “notorious” gangster Dawood Ibrahim: the arch criminal master said to be in league with Pakistan intelligence in spreading all kinds of dastardly terror across the sub-continent, including hijacking a jet from Nepal and blowing up the Bombay stock exchange a few years ago and killing a large number of people.

Shakeel too has his own reputation. He is an “arch gangster and henchman”: blamed for almost every big explosion and murder in his hometown of Bombay.

Last week, I tracked down Shakeel’s people in Karachi with the help of a mobile phone number provided by the Delhi Police’s phone-tapping department. The same crew of line listeners, by following other Shakeel cronies, had exposed the involvement of Hansie Cronje, the South African cricket captain, in match-fixing. Dawood Ibrahim and Shakeel were supposed to be the Mr Bigs in the affair.

If Mr Shakeel is a gangster, then he is at least is a very friendly one. So friendly that it was difficult, once he was contacted, to refuse his generosity. His pressman, ambassador, or whoever it was that answered the phone introduced himself as “Osman”. And Osman announced: “You are our guests in Karachi. Whatever you want, we will provide. DO NOT be shy!”

As it was I was extremely shy. Osman had arrived bearing gifts: not just the flowers but two boxes, which when  opened later, contained what appeared to be gold jewellery and an expensive, if grossly tacky, watch. I tried desperately to hand these gifts back.

“No, no. Mr Shakeel would be very offended if you gave those back,” insisted Mr Osman. That was before he started offering to move me into a guest house, offered me women (“They can arrive here at our table  in minutes”), something to drink (alcohol is banned in Pakistan), or something to smoke (what could he have meant, I do not know).

Later, as my translater was trying to argue to hand back his presents. Osman told him, rather ominously, in Urdu: “Look, we have our way of showing our respect to people. And we have our way of taking up that respect.” Osman and his companion, a Gujerati who spoke little English, started laughing.

My aim had been to arrange a chat on the phone with Ibrahim Dawood. From where-ever he might be hiding. That proved difficult. But at least I could get to find out what gangsters were like.

-  “Are we the sort of Dons you expected? We are not ordinary gangsters, are we?” said Osman, a 45-year-old balding man dressed in a white shalwah-kameez and black slippers, and with rather penetrating black eyes.

One of the tallest Indians I’ve met. I protest I have not been out with that many gangsters. “I’m not sure what the average gangster is actually like,”I said.

As we sat in the Sheraton bar, sipping lime and soda,  Osman became very frank about his gang. Yes they had killed some people in Bombay recently in retaliation to Muslims that were killed by the police in ‘encounters’. “We take things very personally. You know, when they do things to our people, we have to retaliate.”

- What about the bombing of the Bombay stock exchange. Did you do that?

- Well our community was under attack in riots: our women were being raped and menfolk taken and hanged. So we did this bomb. We had to do something.

We are not terrorists, so it gave us no pleasure.

- So you regret it?

- Whatever we did, we did for the Muslims of India.

Osman stood up and took us to his car, a Saab. We were off on an air-conditioned gangsta’ tour of Karachi, a troubled city of 12 million people which also has its share of home-grown talent in this department.

On the way we passed the white fortress, complete with high wall, block houses and machine gun slits, that passes for the Karachi home of the ousted premier Benazir Bhutto. Then on to the long tree-lined avenue where police lay in wait and gunned down her brother in what is known locally as an ‘encounter’, a cross between an execution and a police identity check.

Bhutto’s husband, Asif Zardari, has been languishing in jail for some time accused of being behind the brother’s murder by the police. Osman explained that the origin of the alleged execution was a  marital tiff between Benazir and Asif. The brother, who came to the rescue, was the unfortunate victim.

Finally, we went to one of Karachi’s biggest architectural highlights, the Masjid-e-Tooba, the Tooba mosque, which is a 90 metre diametre perfect dome with a mirror ceiling. The place was closed, so the faithful were praying outside. But Osman had little problem opening the place up and ushering us inside.. The  acoustics are incredible,  turning the tiniest whisper into an echo. It probably helped that we were the only ones inside.

Driving back, we stopped at a barbeque and I was handed a chicken tikka roll. It seemed the wrong time to discuss vegetarianism. Well, in fact, I had brought it up earlier. But the comments were ignored. “Chicket tikka is the best speciality of Karachi,” said Osman. I said it was actually the national dish of Great Britain, but he was not convinced.

Osman and his companion, were beginning to reminisce about Bombay. When we first me, Osman had denied coming from India at all. Now, he admitted to fleeing at the same times as Ibrahim and Shakeel in the late 80s, when they faced imminent arrest.

He started protesting about the climate.  “You know there is no real weather here in Karachi. It is always the same, just a bit hot and humid.

Any weather they  do have is just second hand.”. Later he added: “We do miss our cities you know, our Bombay. There it rains for four months on end. That’s real weather.”

Osman says that he,, like Shakeel and Ibrahim, would love to return if only the Indian government would cut some kind of deal on the charges they would face. “It is our home, you know, our motherland.”

The poor things are such a long way from home. A gangters’ lot is, not always, a happy one.

I’ve just been informed of this very great and thoroughly undeserved honour. Thanks to all involved – and most particularly to all those who are assisting me with my reporting, often at huge personal risk to themselves:

Winners of the 2010 Kurt Schork Awards in International Journalism

Adrian Mogos (Romania) - Local journalist category

Stephen Grey (UK) – Freelance category

London, 19 October 2010

This year’s jury selected two outstanding candidates whose fearlessness and journalistic excellence represent the overall mission of the Kurt Schork Awards for International Journalism.

The 2010 Kurt Schork Awards for International Journalism will honour freelancer Stephen Grey (UK), and local reporter Adrian Mogos (Romania). The awards ceremony at Thomson Reuters headquarters, Canary Wharf on Wednesday 3rd November, will be followed by a reception and panel discussion.

This year’s Schork jury included Jeremy Bowen of the BBC, John Burns of The New York Times, Sir Harold Evans, author and former editor of The Times and The Sunday Times, Rana Husseini, author and human rights activist, and Michela Wrong, freelance journalist and author.

The jury was particularly impressed with the quality of Stephen Grey’s articles on Afghanistan, saying that they represented some of the best coverage anywhere, combining maturity with excellent analytical skills, and making a complex war more understandable.

The jury said Adrian Mogos provided an excellent in-depth investigation into issues of compelling importance. They felt that he showed great initiative, persistence and ingenuity, backed up with excellent research to expose human rights violations.

About the Winners

Adrian Mogos - 2010 Winner, Local journalist category

Biography

Adrian Mogos was born in the town of Cluj – Napoca on 1974. He graduated from the Faculty of Journalism at the West University of Timisoara, following up with postgraduate studies in European Studies in Slovakia. Since 2004, Adrian has worked for the Bucharest-based daily newspaper Jurnalul National. At the same time, he was accepted as a member of the Romanian Centre for Investigative Journalism. In 2009, Adrian was made a fellow of the Balkan Fellowship for Journalistic Excellence, and this summer he was awarded the CEI – SEEMO award for outstanding merits in investigative journalism. Adrian is often invited to share his experience with young journalists in Romania and Moldova.

Winning Stories

• Forged identity – highway to the EU - Jurnalul Naţional
• Fields of Terror – the New Slave Trade in the Heart of Europe – Jurnalul Naţional

Stephen Gray – 2010 Winner, Freelance journalist category

Biography

Stephen Grey is a freelance writer and reporter based in London, covering security issues for both newspapers and television and radio. A former foreign correspondent and Insight Editor of the Sunday Times, he has continued to work for the paper as a freelance, covering most recently the wars in Iraq and Afghanistan, but has also written regularly for publications including the New York Times, Guardian, Prospect magazine and Le Monde Diplomatique. He is best known for his work on reporting the CIA’s rendition program, which resulted in his first book, Ghost Plane. Since 2007, he has been reporting on the war in Afghanistan, particularly in Helmand and Kandahar, where he reported in the spring and early summer of this year. His account of the battle for Musa Qala – Operation Snakebite- was published last year by Penguin. He has made several films for Channel 4 Dispatches, BBC Newsnight, Radio 4’s File on Four, and is currently working on assignment for the PBS documentary series Frontline. Stephen is married with two children.

Winning Stories

• Jonno the brave – The Sunday Times,
• Cracking On In Helmand – Prospect Magazine
• The Gangs of Kandahar – Le Monde Diplomatique
  

March 04, 2007, Sunday Times.
Stephen Grey

JACK STRAW, the former foreign secretary, instructed diplomats to lobby for the release of a convicted criminal described by police and customs intelligence reports as a leading smuggler of heroin into Britain.
Foreign Office telegrams ordered efforts to secure “the immediate release” from a German jail in 2001 of Andreas Antoniades who worked for years as a paid informer for Customs. At the time, he was wanted in Greece on drugs smuggling charges.
Although police or customs informers routinely receive rewards in cash, or reduced sentences if they are prosecuted, Straw’s attempt to help Antoniades avoid trial appears at odds with Customs’ code of practice, which states: “Informants have no licence to commit crime.”
Antoniades, who has never been convicted of a drug offence, was released shortly after the Straw telegrams and has since moved to Dubai.
According to former police officials and intelligence reports, Antoniades, 75, was one of three leading agents for Customs inside the gangs who have flooded Britain with billions of pounds of heroin since the early 1990s. One senior former drugs intelligence officer described the three as being, at one time, among the top five suspected heroin importers into Britain.
Former customs officials say leading drug smugglers often work as moles, motivated by the prospect of destroying rivals or hoping for an “insurance policy” to reduce their sentence if they are convicted. Intelligence from such sources has led to the seizure of huge hauls of drugs. But some question if they also win too much protection.
Antoniades, who confirmed to a Sunday Times reporter two years ago that he had made about £300,000 as a registered informant for Customs, is a Greek Cypriot who was first recruited in the 1950s by Britain to inform on Eoka, a guerrilla group fighting British control of Cyprus.
In 1959, Antoniades was resettled in Britain and turned to crime. He was jailed for four years for “wounding with intent” in a gun attack in west London. Over the following decades, however, Antoniades continued as an informer and became what one Customs official said was “one of the best we ever had”.
In the 1990s, suspicions grew, whether well-founded or not, that he was working with Turkish and Kurdish gangsters. One Customs officer reported that he was “suspected of being involved in organising large shipments of heroin being imported to the UK by various methods”.
But when arrested in Germany in 2001, according to an investigation by BBC Radio 4’s File on 4, to be broadcast on Tuesday, British officials tried to help him avoid trial. One telegram from Straw to the British embassy in Berlin on July 31, 2001, asked officials to “press the case for Mr Antoniades’ release immediately” with state and federal justice ministers. Officials were told to point out that “a public trial in Greece would reveal Mr Antoniades’ long career as an informant for Customs and Excise (1987 to date) and put his life at risk from criminal elements”.
But Straw’s instructions angered staff at the National Criminal Intelligence Service. One former senior officer at the agency, which has since been abolished, said: “At this very time we were preparing to target Antoniades for significant intelligence-led operations. How would the Germans and Greeks have reacted if we subsequently arrested him?”
Antoniades could not be traced for comment last week.
He is not the only controversial informant said to have been used by Customs. Others have included Huseyin Baybasin, head of a Kurdish gang accused of heroin smuggling.
Supported by witnesses, Baybasin claims he and his family moved from Turkey in the 1990s with the help of the British government after he agreed to provide information about the complicity of the Turkish government in smuggling. Baybasin, whose gang was said at one time to control 90% of the heroin trafficked into Britain, is serving life in a Dutch jail after being convicted of conspiracy to murder, drug trafficking and kidnap. He has always denied any involvement in the narcotics trade.

- Sunday Times

first published in New Statesman, Monday 8th March 2004

Stephen Grey argues that when governments are so feeble, unions so weak and corporations so powerful, we should welcome the “compensation culture”

Everyone has their favourite story of the American culture of compensation.
Mine came towards the end of last year from the Iowa court of appeals, which
upheld a jury’s award of $41,267 to a shopper, Judy Krenk, who slipped on a
grape at a supermarket checkout. The parties agreed that “a customer, other
than Krenk, dropped the grape while bagging groceries”, reported the Des
Moines Register. The judge, while noting that “the evidence in support of
Krenk’s claim is less than overwhelming”, said that supermarket employees
“should have known” there was a smashed grape on the floor.
Are we, too, developing a compensation culture? Newspapers highlight such
cases as that of a policewoman recently paid £125,000 for the stress of
working undercover. Concern about the creation of “an atmosphere of distrust
and suspicion” was expressed by the Prince of Wales last year in private
letters to the Lord Chancellor. Solicitors are frequently accused of
“leading on” the victims of accidents for which nobody is really to blame.
Yet there is scant evidence that Britain has anything like a US-style
compensation culture. But, first, another question that is rarely posed: Is
a compensation culture really such a bad thing? Governments are increasingly
reluctant to restrain private companies directly – for example, by imposing
environmental controls that would stop a power plant being built where it
might pollute drinking water, or by introducing laws that would restrain
banks from recommending worthless “investment opportunities”. In such
circumstances, the ordinary person’s only redress against the big and
powerful, and the only hope of persuading companies to act responsibly, is
through the courts. Likewise, when unions have had their powers drastically
curtailed and ministers are reluctant to limit working hours, the threat
that employees will sue companies for ill-health caused by stress is the
only way left of improving workplace conditions. Whatever the law’s
shortcomings, it can be more effective at holding corporations to account
than governments, which are all too often under the influence of private
lobbyists.
The US compensation culture may have led to customers of McDonald’s winning
fortunes for the pain of having hot coffee spilt on them – the worst
consequence of which is that American filter coffee is now undrinkably
lukewarm. But the same culture has created incentives for US companies – in
a country that supposedly abhors regulation – to deal with asbestos
injuries, diet drugs, faulty cars and vans, life insurance sales products
and tobacco additives. Thirty years of compensation litigation have forced
manufacturers to re-engineer their products and make them the most
consumer-friendly in the world – from child- proof cigarette lighters to
ergonomically designed keyboards. In the UK, even as our courts reject
similar consumer legal actions, we free-ride off the innovation that
attention to safety in the US has encouraged.
In the US, investors will get roughly $3bn in compensation from Wall Street
banks that encouraged investments in dotcom companies from which they were
earning banking fees. At least one US financial magazine considers this a
derisory sum. Here, the compensation for victims of the Potters Bar rail
crash in May 2002 is likely to be in the low thousands. The victims included
Agnes Quinlivan, whose daughters were paid an initial £10,000 and had a
subsequent claim for damages rejected by Railtrack. Legal aid to challenge
this and other awards has been denied. Insurance cover for solicitors to
fight the claims on a “no win, no fee” basis has also been refused. Yet
Railtrack was widely praised for saying that, without accepting legal
liability, it would pay compensation to the victims as though it were fully
liable. Colin Smith, Agnes Quinlivan’s son-in-law, argues that “Railtrack
lied to us when they promised to deal with the families’ cases with sympathy
and care”.
Britain, then, has not so much a compensation culture as a compensation
deficit. Louise Christian, solicitor for the Potters Bar families, says that
in America, they might get a million dollars or more. She compares the
Potters Bar victims with those of the Lockerbie bombing. Negotiations led by
US lawyers secured a $10m pay-out from Libya for each victim’s family,
regardless of their economic circumstances or whether they had dependants.
Walter Olson, a fellow of the conservative think-tank the Manhattan
Institute (and an opponent of the compensation culture who argues that
litigation has produced more safety in the US than you could ever want),
agrees that £10,000 would be a piffling sum for a fatality in the US. “It
would be more or less just the rounding error in the calculations,” he says.
“Although it varies from state to state, you could expect maybe a hundred
times more to be paid out.”
Olson points to the example of nine-year-old Perrize Washington, who drowned
on 13 June 2001 while on a field trip to a YMCA pool in Jackson,
Mississippi. After a trial televised on Court TV, the case was settled last
November for close to the family lawyer’s demand of $10m.

By international standards, the British compensation bill is still low. A
study last year found that as a percentage of GDP, the UK has the lowest
tort cost in the industrialised world – 0.6 per cent against, for example,
1.9 per cent in the US, 1.7 per cent in Italy, 1.3 per cent in Germany and
1.1 per cent in Australia. The belief that compensation is bleeding the
nation dry and that lawyers are constantly on the prowl is largely a myth
spread by the insurance industry to persuade more people to take out
policies. Over the past three years, accident claims filed to the British
government’s Compensation Recovery Unit have actually fallen from 743,593 to
706,715.
It is probably true that the number of employment compensation claims has
risen. But companies complain that insurance companies often find it easier
to accept dodgy claims and subsequently raise premiums than to contest bad
cases.
As for medicine, the problem is not so much an excess of compensation
demands as an excess of deference in the face of medical incompetence, as
shown by the cases of Harold Shipman and the Bristol Royal Infirmary, which
was able to continue for years with an alarmingly high death rate following
heart surgery on children.
Disputing Doctors, a little-noticed but powerful book by Linda Mulcahy
published last year, showed, for example, that most medical mistakes rarely
lead to complaints, let alone lawsuits – even in the US. The most
comprehensive study of medical mistakes, she wrote, found that in American
hospitals, nearly 4 per cent of patients suffered an injury which prolonged
their stay or resulted in a measurable disability; nearly 14 per cent of
these injuries were fatal. This is equivalent to 18,000 Americans dying each
year due to preventable mistakes in hospital. (A smaller-scale study in the
UK found that 7 per cent of patients suffer mistakes.) Yet, according to a
study in 1985, only one in 25 negligent injuries results in compensation. A
more recent study found seven times as many medical mistakes as compensation
claims.
Allegations that the new no win, no fee system in Britain encourages
compensation claims are false. The introduction of no win, no fee was
followed by the withdrawal of legal aid for most personal i
njury cases. If
anything, the new system makes things worse for the accident victim, because
it gives lawyers little incentive to pursue cases that aren’t “dead certs”.
In the US, lawyers can claim up to 30 per cent of the damages they recover;
in the UK, they receive only a small “uplifted fee”, which provides little
incentive to take on an expensive and risky case.
There is also a difficulty in taking on big corporations under English law.
Under the US system, each side pays its own costs. In England, if the
alleged victim loses the case, he or she pays the company’s costs, including
its expensive lawyers. The English system also prevents a lawsuit being
brought on behalf of an entire class of victims. The consequence, says
Stephen Alexander, a partner of Class Law solicitors, is that if a company
makes an illegal profit – for example, by fixing prices or giving
negligently bad investment advice – there is “no plan for the disgorgement
of that ill-gotten gain back to the victims”.
The UK should probably not follow America all the way. It would be a good
thing to bring many disputes out of the poisonous and expensive atmosphere
of the courtroom – a third of all compensation payments is absorbed by
administrative and legal costs – and into mediation. But we should try to
increase public access to the law and strengthen, rather than diminish, the
culture of compensation. Whether the bad guys are Microsoft or BP, we can’t
leave it to US courts to police our corporate world.

More than 250,000 people languish on hidden NHS waiting lists. Some die

before even appearing in official statistics. Insight investigates.

(Published in the Sunday Times, May 5, 2002)

When Iris Bailey suffered chest pains and was diagnosed with angina, she was

told that she needed a test to show how well her blood was circulating. The

waiting list for the thallium scan was three months – a delay not included

in published government figures.

Bailey, having worked as a hospital porter, accepted it with good grace and

put her faith in the National Health Service. The grandmother from Harlow,

Essex, kept busy helping to plan her son Gary’s wedding and hoped her

condition was not serious. Three weeks before she was due to have the scan,

she again suffered chest pains. This time it was decided that she needed an

angiogram, a heart test, at St Bartholomew’s hospital in London and that the

wait would be two weeks – another delay that many hospitals do not count in

the official waiting list figures.

David, another son, was so concerned that he sought assurances that his

mother would not die waiting for the angiogram. On the day he handed a

letter to the hospital’s management his mother, 75, had a fatal cardiac

arrest. It was more than four months since she had first felt ill in October

2000 but none of her waits counted in official statistics.

“For anyone to die waiting for a test is atrocious,” said David Bailey.

Independent health groups, such as the King’s Fund, say it is an indictment

of the waiting list system – a key measure of hospitals’ performance. Bailey

was an invisible patient left to languish.

What is even more shocking is evidence that hospital trusts are discreetly

moving patients from the published waiting list to the hidden ones.

Wittingly or not, it helps the government to trumpet improvements in NHS

performance.

The truth is, however, that many thousands of patients, perhaps similar to

Bailey, will still be waiting for tests and treatment that could save their

lives. An investigation of the way hospitals and the Department of Health

count NHS waits has revealed that an estimated 250,000 patients do not

appear in published figures.

To be fair, some will be waiting for scans or tests that will reveal nothing

untoward. For them the delay will not matter clinically, despite the anxious

wait. But for others, such as those needing radiotherapy for cancer, the

wait could be lethal.

As Joseph Meirion Thomas, a consultant surgeon at the Royal Marsden

hospital, puts it: “I would want to give pre-operative radiotherapy to

between 5% and 10% of my patients with sarcoma (cancerous tumours) to give

them a surgical advantage, but none gets it because of the waiting list.

“It’s disgraceful. It’s a waiting list that is creeping up and it’s a

waiting list you don’t know about – the hidden waiting list.”

IN opposition, Labour castigated the Conservative government over its

failure to publish details of patients waiting to see a consultant after

referral from a GP. Things would be different, it promised, if Labour was

elected.

Subsequently two published waiting lists set the standard. The first is the

outpatient list which shows the waits from referral by a GP to the first

appointment with a hospital consultant. The second is the wait for treatment

in hospital as an admission or a day case.

These figures, however, still do not cover the whole pathway from “pain to

scalpel”. Missing are waits for diagnostic tests, often to see whether

surgery is required; they can be as long as 20 months. The government says

these figures are not collected centrally and are not available.

Indeed, John Hutton, the health minister, told the House of Commons in

February: “Data is not collected on the number of patients waiting for

angiograms.”

The reality is that angiogram waiting lists – and lists for other diagnostic

tests – are being compiled in hospitals across the country. They are just

not being published.

One manager at the Norfolk and Norwich University Hospital Trust said, “I’ve

got these waits on the wall in front of me”, but refused to release the

figures. Other trusts also declined to reveal the figures after seeking

guidance from the health department.

Yet some hospitals are willing to release the figures on request; some even

include these delays in their official waiting list figures. They are now

finding themselves under pressure from the NHS Executive to remove them.

“They tried to persuade us to remove angiography off the waiting list but we

refused,” said one manager at a hospital which records angiograms in its

figures. “We think it’s a proper surgical procedure.”

The second category of tests being excluded from the official lists are

endoscopies, used to help to diagnose cancer among other things. Those

hospitals that have been counting patients waiting for these tests are now

being instructed to remove them.

In a letter to chief executives of trusts in southeast England last October,

Bob Ricketts, then an NHS regional director, advised that the removal should

be gradual to “avoid sudden lurches in figures”.

A third large category of excluded diagnostic tests are computerised

tomography (CT) scans and magnetic resonance imaging (MRI) scans, which can

be used to diagnose cancers, cardiovascular diseases and bone disorders.

Previously unpublished data from more than 30 trusts, obtained by The Sunday

Times, reveals long delays and huge regional variations for such scans.

At the Blackpool, Fylde and Wyre Hospitals NHS Trust there were 523 patients

waiting up to 14 months for a CT scan at the end of March and 1,753 patients

waiting up to 20 months for an MRI scan. But at Hillingdon Hospital NHS

Trust there were just 89 patients waiting a maximum 21 days for an MRI scan.

At South Devon Healthcare NHS Trust there were 227 patients waiting up to 18

months for angiograms on March 31. But the maximum wait at Bradford

Hospitals NHS Trust was five weeks.

Hospitals point out that urgent cases can be given priority. The health

department claims that because such scans may be for preventive purposes, or

show nothing wrong, it is not meaningful to include them in the published

waiting list figures. Try telling that to a patient who finds, via a delayed

scan, that his cancer has become inoperable.

BUT perhaps the most damning omission from the official lists is for

radiotherapy cancer treatment. Alan Milburn, the health secretary, has made

tackling cancer a priority. But hundreds of radiotherapy patients are on

hidden waiting lists of up to six months.

Some cancer centre managers complain that their “invisible” patients are

given lower priority because their treatment does not count towards official

waiting list targets. “We asked for in excess of Pounds 1m (for this

financial year). It was reduced to Pounds 650,000 and has now been reduced

again,” said Jo Yardley, general manager of Kent Oncology Centre in

Maidstone.

“The waits cause immense anxiety yet I have never reported on radiotherapy

waits for any (national) performance programme. It’s something that we have

been crying out for for years.”

Guidelines from the Royal College of Radiologists stipulate that breast

cancer patients should receive post-operative radiotherapy within a month.

But it is not uncommon for patients to suffer delays of up to three months -

a delay that appears on no published government waiting lists.

There are cases such as Joy Barthorpe, 72, of Battle, East Sussex, who was

diagnosed with breast cancer last October and had her operation on December

28. She has been told that her radiotherapy will not start until June 24.

Thomas Liston, 46, from west London, was put on a three-month wait for

radiotherapy for a brain tumour. His waiting time was reduced but he died

earlier this year before he received treatment.

These are not isolated incidents. The dangers of delay are reflected in a

report published in the British Medical Journal in January 2000. It said:

“Six weeks is the approximate volume doubling time for many tumours and

introducing an additional delay of four weeks between planning and starting

radiotherapy must prejudice outcomes.”

THEY are calling it Not The Waiting List. That is the title of a report that

the Association of Community Health Councils for England and Wales is

preparing to illustrate how many different types of waits are excluded from

government figures. Whether all of them should be part of published waiting

lists, or can be collected in practical terms, is debatable. What is clear

is that waits for certain diagnostic tests and treatment for some serious

illnesses are at present hidden from public scrutiny.

As Liam Fox, Tory health spokesman, said: “If you are interested in clinical

outcome, then one of the critical factors is access to diagnostics. The

horrendous delays in getting access may often mean that patients may die

before they get the treatment that they require.”

Hospital managers admit the disarray. Several, such as Plymouth Hospitals

NHS Trust, say they do not count angiograms, while several others, such as

the Newcastle upon Tyne Hospitals NHS Trust, say they do.

It creates a system that is both confusing and distorting, skewing managers’

attention away from life-threatening diseases to treatments for mundane

conditions that happen to reduce published waiting lists.

“When the money comes in, the chief executives want to put the money into

achieving the targets over which they will get sacked,” said Hilary Thomas,

professor of oncology at the Royal Surrey County hospital. That means

concentrating on published waiting lists.

“The public should know that one patient might be getting their varicose

veins surgery done to meet some silly target in a manifesto and another (who

does not appear on the waiting list) might not get radical treatment for

cancer and that may make a difference to whether they live to old age or

not.”

That, says Thomas, is “morally wrong”.