"District health boards are caught between a rock and a hard place over the funding system for elective surgery," said Mr Ian Powell, Executive Director of the Association of Salaried Medical Specialists, today. Mr Powell was responding to the decision of the Southern District Health Board to clamp down on the number of elective operations done in order to avoid cost overruns.

"The government expects district health boards to meet the targets it sets them for the number of elective operations they are required to do within a maximum waiting time." The maximum waiting time was previously six months, is now five months, and reduces to four months next year.

"If they succeed they are financially rewarded and if they fail they risk financial penalties."

"But if they do too many operations they can get hauled over the coals, especially if they have a financial deficit. It is a fine line between under and so-called over-performance. They are expected to perform with the accuracy of an Olympic Games shooter."

"It is a perversity that a system of financial penalties and incentives can create a situation where district health boards are punished for improving accessible patient care for those who need it," concluded Mr Powell.