NHS hospitals will have to see a third of a million more outpatients over the next year, and guarantee an outpatient appointment within two weeks to any woman with suspected breast cancer.
Health secretary Frank Dobson has given waiting-list buster Peter Homa a brief to cut outpatient waiting times following the fall of inpatient waiting lists to pre- election levels.
And last week health minister Baroness Hayman launched the government's two-week specialist appointment guarantee for all women with suspected breast cancer.
But many doctors say this target is impossible. GPs fear that they will be forced to refer more cases and surgeons fear there are not enough breast cancer specialists to cope.
Mr Homa told HSJ: 'I would expect that in some places there will be a greater challenge than others to meet the target, but it is only right and proper that we work to ensure that it is deliverable.'
A Department of Health spokesperson agreed that some women may not be seen within two weeks, but said that patients would be able to cite ministers' promise to any hospital offering a longer wait for an appointment.
Mr Homa said that pushing through the extra outpatients by next April was 'a very substantial target'. But he was confident that it could be met by passing on best practice, reducing non-attendance and focusing more on one-stop delivery and other new ways of delivering services.
NHS Confederation chief executive Stephen Thornton welcomed the involvement of Mr Homa in addressing outpatient waiting times, which he said were the cause of most anxiety for many patients. But he cautioned: 'I am concerned that the government might be raising expectations too much at a time when health authorities and primary care groups have already formulated pretty tight commissioning plans. To throw this in at such a late stage might be a little unrealistic when they have got so much other work to do and things to spend money on.
'The target of an extra 330,000-odd patients is not huge, so it may not cause too many problems although, of course, at least a third of those patients may need an inpatient appointment, so it could have a knock-on there.'