Using the six-month period before developing and using the Dynamic Guideline, all cases of elective surgery in a senior population for QualMed HMO in Pueblo and Colorado Springs, Colo., were set aside for later review.

One such routine has been a battery of preoperative laboratory tests on healthy patients undergoing elective surgery. The value of this practice was recently reviewed at the Mayo Clinic.

The procedure, known as autologous transfusion, promises to change preparation for elective surgery.

Under the proposal by Cardiff and Vale University Health Board (UHB), smokers and patients with a body mass index (BMI) over 40 must complete the courses before they are listed for elective surgery.

Elective surgery includes corrections of non-urgent medical conditions such as haemorrhoids or a hernia, as well as selected cosmetic procedures.

To give the Minister his political credit, there is more elective surgery being done.

"Ten years later the rates had changed so that, although women from a lower social background were more likely to have emergency sections, there was no difference between them and women from a higher social background in elective surgery rates," she added.

Colin Ferguson, the Royal College of Surgeons' director of professional affairs for Wales, said: "Despite the improvements in the last several years in elective surgery and in waiting times, the use of targets to achieve that has been to the detriment of the emergency surgical service.

More than 14,000 extra patients received elective surgery in the first six months of the Rudd Government's 'blitz' on lengthy public hospital waiting lists.

Aberconwy AM Gareth Jones's suggestion comes as healthminister Edwina Hart reviews services for patients who currently go to Walton Centre for Neurology and Neurosurgery in Fazakerley on Merseyside for planned, elective surgery.

THE NHS needs to monitor the performance of all providers of elective surgery so patients can make informed choices about their care, experts warned today.