INEFFICIENT, poor value for money, weak in performance, a system that rewards failure - these are the damning descriptions of the NHS in Wales' approach to waiting times, delivered today by the National Audit Office for Wales (NAO).

Speculation is rife among Assembly gossips that its hard-hitting conclusions led to Jane Hutt's removal last Monday from the post of health and social services minister.

That really does not matter. If the waiting times position in Wales is as dire as painted by this report, gossip is the last thing we need.

The NAO pulls no punches. It acknowledges Wales' different health priorities and an approach focusing on underlying, long term health problems which has created differences in waiting times targets and priorities compared to England and Scotland. But it concludes:

* The rate of improvement (in waiting times) in Wales has been slow;

* The current situation in Wales is unfair, particularly compared to England and Scotland;

* Urgent and concerted action is needed;

l* The use of existing capacity is inefficient. Patients stay in hospital too long, there are long intervals between patients when beds are unused, and too few patients are treated as day cases.

Widespread use of waiting time initiatives - extra operating sessions, weekend sessions - which use one-off funding, treated more than 40,000 patients over the past two years, costing 36 million. But the report slams this practice as providing "neither good value for money, nor sustainable reductions in waiting times."

Initiatives, it says, "treat the symptom - patients waiting - rather than the causes of long waiting times."