A highly critical report into the way waiting lists are tackled in Wales says patients are waiting too long to see consultants and for surgery.
Dr Brian Gibbons has already said lessons must be learned
The auditor general for Wales said NHS waiting times must be driven down but there was no clear strategy to do so.
His report is published the same week that Jane Hutt was sacked after five-and-a-half years as, the Welsh assembly's first health minister.
Her successor Brian Gibbons said waiting times fell in the past year.
The failure to reduce waiting times in Wales had been a repeated criticism of Ms Hutt towards the end of her tenure as health minister.
Opposition parties in the assembly said the report must mean a change of policy as well as minister.
The report describes a Welsh health service where waiting time targets are higher than those in England and Scotland, but it concludes that it is a service that had generally failed to meet them.
Ms Hutt had faced criticism from opposition AMs and Labour MPs
Although there has been some success in reducing the longest waits, the report finds that success still depends on where patients live in Wales.
Between 2002 and 2004, Welsh Assembly Government initiatives cut waiting times by funding extra operations.
Under them they treated 40,000 patients at a cost of £36m. But the auditor general's report says the initiatives have not resulted in an any sustainable reduction in waiting times.
It says the assembly government has not produced a clear strategy to reduced waiting times, and its statements of targets have not been consistent.
There is, however, some praise for the second offer scheme which guarantees all patients on inpatient waiting lists an offer of alternative treatment if they are likely to wait over 18 months, or 12 months by the end of March 2005.
The report says the scheme has the potential to reduce waiting times, but will "need to be managed carefully".
Dr Gibbons had already admitted lessons needed to be learned from reforms in the English NHS and, in a statement, said waiting lists in Wales had fallen significantly over the last year.
"By October last year we had seen a reduction of 38% in the number of people waiting over 12 months for an operation and a drop of 86% in those having to wait over 18 months," Dr Gibbons said.
"Two thirds of people currently waiting for treatment have also been waiting less than six months."
Dr Gibbons added: "If we can implement (the report's) points effectively then patients' experience will improve.
"It's a very important document - there are lessons to be learned."
Plaid Cymru said the report was "the most devastating critique of the assembly government's health policy so far".
The Conservatives said the report's findings were "horrific" while the Liberal Democrats described it as "shocking" and demanded a change in health policy.
The chairman of the British Medical Association's Welsh council, Dr Tony Calland, said: "Inexperienced local health boards have been unable to assess the demands on hospital services coming from general practice and the community."
He added: "It is the shortcomings of these management systems and of the commissioning of services that make a substantial contribution to the appalling state of affairs described in this report."