The deterioration in Scotland’s elective waiting times accelerated dramatically in the quarter to September, according to figures just released by ISD. But you won’t have read about it in the press.

“Hospitals are no closer to treating all patients who need procedures within 12 weeks…”, said The Herald, “…the target to treat patients within 18 weeks of referral is being met”.

“The figures showed the proportion of patients starting treatment within 18 weeks of referral by their GPs has fallen from 91.1 per cent in June this year to 90.1 per cent in September”, said The Telegraph.

All true. But not all relevant. Those statistics about 18 week waits are based only on those patients lucky enough to be treated, not those who are still waiting. So long as patients remain on the waiting list – no matter how long they have been waiting – they are not picked up in the ’18 weeks’ figures.

So to understand the true state of Scotland’s waiting lists, you need to look at patients who are still waiting: “ongoing waits” in the sensible parlance of the Scottish NHS.

At the less-dramatic end of things, the latest figures tell us that the number of inpatients and daycases waiting longer than 12 weeks has risen a bit, but is still below 2 per cent of the waiting list. This low number demonstrates the relative success of the legally binding Treatment Time Guarantee.

But outpatient long-waits do not enjoy such legislative protection. And the number waiting longer than 12 weeks is shooting up like a rocket.

Over 12 week ongoing waits

This growth is fuelled by the remorseless rise in the total number of outpatients on the waiting list: a longer queue means longer waits, and as the snout of the waiting list pushes past the 12 week mark the number of long-waiters shoots up quickly.

Total waiting list

(All these numbers exclude Lothian who have been a special case in recent years.)

With over-12-week outpatient waiters having doubled in a single quarter, approaching 8% of the outpatient waiting list, it is difficult to justify the bland headlines that greeted these statistics.

What will happen next? Will outpatient long-waiters plateau in the next quarter, following the usual pattern? Or carry on rising inexorably as they did in 2012?

Actually, neither outcome would be good news.

Restoring short waiting times in Scotland requires the outpatient waiting list to start shrinking, not growing, with all the knock-on effects for inpatient and daycase waits that go with that.

Outpatient waits have been the poor relation in Scotland for too long. It’s about time they got the attention they deserve.