The government must end a system by which specialist hip surgeons are offered free travel and accommodation by the manufacturers of artificial joints, the all-party House of Commons public accounts committee says today.

Around one in ten orthopaedic consultants accepts incentives which have "the potential to distort clinical judgment" and affect value for money in the NHS, according to the MPs.

A similar proportion is using prostheses whose effectiveness has not been proven, while half the consultants in the field are doing less than one operation a week.

More than 43,000 hip replacements are performed each year, making the surgery one of the most com mon procedures in the NHS. But the committee says the incentive system must stop.

"Innovation can bring benefits to patients, but there need to be strict safeguards for new models with little or no track record," the MPs say.

There are 64 types of prostheses on the market in Britain but not all have been approved by the National Institute for Clinical Excellence, the government's value-for-money watchdog.

The Department of Health said yesterday it was considering whether surgeons should carry out a minimum number of operations but the NHS had undertaken "a significant programme of work" to improve quality of surgery.

James Meikle