Another 500 people are being dropped from Hawkes Bay Hospital waiting lists.
The Hawkes Bay District Health Board's "catch up and keep up" plan, approved at this week's board meeting, means 302 people will be told they no longer qualify for surgery.
They will be sent back to their GPs to discuss alternative care.
Another 206 patients will be transferred from the surgery waiting list to an "active review" list and will be checked every six months in case their condition deteriorates.
Hawkes Bay's waiting lists are among the longest in the country.
In May last year, when a new booking system was introduced, about 1200 people were dropped from the list. Last September a similar number were removed from the ultrasound list.
Chief executive Chris Clarke told this week's meeting that the board had made false promises. "These people were never going to get surgery, given the resources we had."
He said the board had to be honest and either tell people they would get an operation within six months, put them on active review or send them back to their GPs because other patients had higher priority.
Management was working with clinicians to put patients on a priority list and make "some difficult and unpalatable decisions".
Mr Clarke said Hawkes Bay would meet Health Ministry guidelines - which state that no one should wait more than six months once treatment is promised - by June 2005 but it would be difficult without extra funding.
- NZPA
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