The auditor general for Wales has recommended the Assembly government scraps its blanket target for reducing sickness absence rates in NHS trusts.
His report, published today, found rates had fallen from an average of 6 per cent in 2002-03 to about 5.3 per cent today.
However, a statement from the auditor general, Jeremy Colman, said: "Absence rates still vary greatly between trusts - between 4.1 to 7 per cent - and most trusts doubt whether the 4.2 per cent target represented a realistic goal."
He called for the target to be dropped in favour of "a smarter approach to target setting which reflects the circumstances of each of the new local and national NHS bodies".
In 2004 two reports drew attention to high absence rates and pointed to problems with workforce management.
The auditor general said management had improved generally but that sickness absence remained "a significant problem".