Figures due to be published next week are expected to show that the government has achieved its election pledge of reducing the number of people on waiting lists by 100,000.

However, doctors, patients and the opposition parties have expressed concerns at the length of time people are waiting to get hospital appointments.

They argue that focussing resources on reducing numbers simply increases the time patients have to wait for complex operations.

'Short-term targets achieved'

Speaking to the BBC, Mr Dobson said: "We've got a short-term strategy for bringing down waiting lists and waiting times, and we have achieved that."

The NHS performance figures for England published last December showed that although waiting lists were shrinking, waiting times were going up.

Latest figures - covering the three months to 31 March - show that 153,000 patients are waiting 26 weeks for an outpatient appointment.

This is up from 126,000 in the same period to 31September 1998.

However, the Department of Health said these figures must be seen in the context of rising consultations.

Outpatients 'list buster'

On Monday, the government announced that 175,000 more people got an outpatient appointment to see a hospital specialist in the year to March 1999 than in the previous year.

It announced then that it planned to increase consultations by a further one third of a million next year.

Mr Dobson said he would ask Peter Homa, described as the "national list-buster" to turn his attention to outpatients appointments.

But the British Medical Association (BMA) said the government's plans would be difficult to carry out unless more doctors were recruited.

Patients wait longer

Dr Michael Goodman, deputy chairman of the BMA's consultants committee, said: "Hospital outpatient clinics are already seriously overbooked, sometimes well in excess of Royal College guidance.

"This means both patients and doctors often feel the consultation is very rushed.

"Senior doctors are often called out of clinic to attend to emergencies, leaving patients anxious and frustrated and the system is creaking under the strain.

"While a list buster might help, the only viable solution is an urgent expansion in the number of hospital consultants.

"There is huge unmet need, with patients waiting a very long time for their first outpatient appointment, but without more doctors, dramatic rises in throughput are simply not achievable."

Focus on quality

On Friday, Mr Dobson accepted that 153,000 patients were waiting more than 26 weeks for an outpatient appointment, but said the government's next target was to reduce that time.

He said that the government's long-term strategy was to improve quality in the NHS.

Doctors have consistently called on the government to focus on quality not quantity since it began its drive to reduce the number of people on waiting lists.

The BMA has argued that it is easier to complete large numbers of simple operations, such as cataract surgery, in a short time, than to treat patients requiring more complicated procedures on hold.

This distorts clinical priorities, the BMA says, because while cataracts pose no long-term threat to health, a complicated heart operation could save a patient's life.

A&E modernisation

Central to the government's plans is a £115m modernisation scheme for casualty departments.

The money will be used on new diagnostic equipment, admissions units and observations wards, among other things.

The Department of Health says this will help cut waiting times.