NHS chief executive Nigel Crisp has defended the service's record in delivering the NHS plan targets and categorically stated that the major targets, such as the maximum four-hour accident and emergency wait, will be achieved on time.

Responding to last week's HSJ editorial (page 17), which claimed doubt and pessimism about the targets had replaced the initial euphoria over the plan, Mr Crisp maintained that 'all the evidence shows we are going to hit our targets'.

'If you look at our record, we are hitting our major targets and hitting them early. There are very large numbers involved in modernisation and service improvement and making underlying changes for the better, ' he added.

'People have concerns and worries but we are hitting them [the targets], and by the end of March I am confident we can achieve the maximum 15-month wait, and our target of 75 per cent of patients being seen in under four hours in A&E.'

His comment followed an Audit Commission report which concluded that A&E waiting times are getting worse.

It also comes against a background of an increase in the number of long waiters in the most recent statistics.

Mr Crisp acknowledged the difficulties trusts are facing and that the 'service is under pressure' but criticised the 'destructive' tone of HSJ's coverage and the 'counsel of despair'.

'Of course there are problem areas, but We have got to work on them. I know It is very tough . . . but We are moving in the right direction, ' he said.

He added: 'If there were not difficulties we wouldn't have to modernise.'

He stressed that in key clinical areas such as coronary heart disease and cancer performance, targets were being exceeded.