PATIENTS in need of urgent hip replacements are being overlooked by consultants trying to meet waiting list targets, according to a report published yesterday.

One in ten consultants who carry out hip replacement operations give precedence to people who have been waiting longer for an operation over more clinically urgent cases, said the National Audit Office (NAO) report.

The report echoed protests by senior medics at Newcastle Hospitals NHS Trust earlier this week after a minor infringement of waiting list rules led to the trust losing one of its three stars.

The group, which includes 22 consultants, stated: "The Newcastle specialists were not prepared to see patients in other than order of clinical priority and as a consequence the trust has been penalised."

Dr Evan Harris, Liberal Democrat shadow health secretary, said: ''Ten per cent of consultants are saying that their decisions are now made on the need to meet Government political targets rather than on clinical priority.

"This means that about 5,000 patients have their medical needs subordinated to those of politicians."

The report also cited research by the British Orthopaedic Association which found that, in March 2001, 52 out of 100 orthopaedic units that responded had been asked to operate on long waiting time patients at the expense of more clinically urgent cases.

Public Accounts Committee chairman Edward Leigh said: "This is in flagrant disregard of the fundamental principle that those in greatest need should be treated first - and it must stop."

Dr Bill Ryder, chairman of the Northern region consultants committee, said: "I don't think there is any doubt at all that this going on. The trust management are under absurd pressures to meet waiting list targets. Their jobs are on the line and there is an enormous amount of bullying from the Department of Health."