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Ministers are ordering a crackdown on "hidden" waiting in the NHS in England.

Hospitals currently have to see non-urgent patients within 18 weeks but there are nearly 250,000 on lists who have waited for longer than this.

Ministers believe there is not enough incentive for these patients to be treated, meaning some are left "languishing" unnecessarily.

They are demanding NHS managers reduce the number of long waiters by about 50,000 by April.

The whole backlog is not being targeted as it is accepted that some patients wait longer than 18 weeks for justifiable reasons - perhaps because they have to lose weight before having surgery or for personal or work commitments.

There is particular concern within the government about some of the longest waits being seen. Among the 250,000 who have been waiting for longer than 18 weeks are just over 100,000 who have waited for more than six months and 20,000 waiting at least a year.

However, these figures should be seen in the context of the total size of the waiting list, which currently stands at 2.6 million for non-emergency care, such as knee and hip replacements.

Health Secretary Andrew Lansley has blamed the targets established by the Labour government which he said had created a perverse incentive whereby the NHS was free to leave patients "languishing" on waiting lists.

He said: "Because of Labour's perverse approach, the NHS actually had an incentive not to treat patients.

"The new approach we will take from next year will clamp down on this practice. We will reduce the number of patients on hidden waiting lists, ensuring everyone gets access to the treatment they need."

Jo Webber, deputy policy director of the NHS Confederation, said she welcomed what the government was trying to do.

"This indicator will shine a spotlight on one of the many aspects of patient waiting the government does not currently measure."

But shadow health secretary Andy Burnham said the government was having to introduce these new rules because of Mr Lansley's failure to "get a grip" on waiting times.

And he added the government's overhaul of the NHS would just make matter worse as NHS hospitals would become distracted by competing with the private sector.

"This will take us straight back to bad old days of the Tory NHS, where patients are forced to choose between waiting longer or paying to go private."

And Professor John Appleby, of the King's Fund, a health think tank, questioned whether the current system was creating perverse incentives.

He said there was some evidence the longest waits were actually going down.

"If they really want to tackle the longest waits they could simply say that no patient should wait longer than a year before treatment begins," he added.