Do waiting list initiatives discriminate in favour of those in a higher socioeconomic group?

The UK has a publicly funded health care system with open access to all. In the past, demand for services overwhelmed the resources available. Recent government initiatives have attempted to address this. To achieve shorter waiting times (and guaranteed waiting times), access to additional services has been purchased from the private sector under short-term initiatives, often at sites firth of the home health board. There has been a suspicion that patients from higher socioeconomic groups have benefited differentially from this by rapid access to private health care facilities, due to ease of transport. The aim of this study was to analyse whether a patient's socioeconomic group influenced their access to, and place of, surgery. Patients undergoing a primary total hip or knee arthroplasty in a single health region over a three-year period were identified and their social group was determined by postcode address. Analysis of 3888 patients operated on in four different treatment centres comparing the distribution of patients according to their social group, revealed no bias in the provision of treatment. The study group was comparable to the control population in that health region. In conclusion, the introduction of health policies to reduce time to orthopaedic treatment within one health board area has not resulted in patient bias.