Health board general managers and trust chief executives will be expected to 'sign up' to their share of the Scottish waiting list cuts target.

They will be asked to make a 'personal commitment' to their organisation's target and the elective work involved when a 20m tranche of waiting list cash is released this autumn.

'Within each board or trust there has to be someone who is living this and living it all the time,' Scottish waiting list buster Tom Divers said last week.

Speaking at an Institute of Health Services Management conference in London, he said firm recommendations on how the 20m challenge fund should be allocated had gone to Scottish health minister Sam Galbraith.

The cash will follow an initial 20m already distributed on the basis of weighted capitation, and leaves 5m in a 'reward pot'. Mr Divers said his team was likely to make recommendations on that money in December.

'What board general managers and trust chief executives will be asked to do as the second tranche is allocated is sign for it as a commitment to what they will achieve,' he said. 'That is how

serious this is.'

But Mr Drivers warned that waiting list reductions had to be sustainable. 'I see no point in the lists getting crashed down to a level where they cannot be sustained and they then start to build up again.' Health boards and trusts also had to be realistic about the growth in activity implied by waiting list reductions, said Mr Divers.

'I have been in two trusts where the chief executive started by saying, 'you need to know that the activity agreements we are being paid for are at March 1997 levels'. We cannot play those games.'

See News Focus, pages 12-13.