DELAYS in formal approval of a multi-million-pound scheme to slash orthopaedic waiting-times in Gwent mean patients are unlikely to see the benefits until well into 2006.

Gwent Healthcare Trust bosses will meet their counterparts from Gwent's five Local Health Boards today to discuss the value for money of a proposal to boost orthopaedic capacity at Newport's St Woolos Hospital.

Funding for the scheme, involving the development of new operating theatres, orthopaedic beds and staff, was approved in principle by the Assembly in February last year in the aftermath of the Edwards Report into Gwent's orthopaedic services.

The project will cost almost £6m to establish, and will allow for 2,000 more orthopaedic treatments and more than 5,000 extra outpatient appointments a year.

But the Local Health Boards (LHBs) - Newport, Caerphilly, Torfaen, Blaenau Gwent and Monmouth - have concerns over the running costs and the scheme's value for money, and have refused to formally approve the trust's outline business case.

The case was submitted to the Assembly in April 2003, but the LHBs, which replaced Gwent Health Authority that month as the commissioners of the area's health services, have demanded answers to their concerns. The Edwards Report stressed the urgency of finding a solution to a chronic lack of capacity in orthopaedics in Gwent, but the trust has now informed Gwent Community Health Council that it will be 19 months from approval before the scheme will be fully operational.

Even if that approval comes from LHBs tomorrow, the Assembly will have to approve it too, and that will take the full start-up into spring or summer 2006, more than three years after Assembly Health Minister Jane Hutt first agreed.

The Edwards Report, published in January 2003, followed a high- profile review of Gwent's orthopaedic services during late 2002 by NHS troubleshooter Professor Brian Edwards.

He was called in by Ms Hutt after the number of Gwent patients waiting more than 18 months for orthopaedic surgery rose through that autumn. The outline business case predicts that it will help cut treatment waiting-lists for joint surgery to less than a year.