Fears by an Airedale NHS Trust boss that the Government's demand to reduce waiting lists may cause cuts to services have been mirrored by a national health watchdog.

Doug Farrow, Airedale's planning and marketing director, has warned that ambitions to improve cancer, heart and emergency care could be jeopardised by the Government's demands.

His comments are mirrored by findings in Getting Better, a Commission for Health Improvement (CHI) report that says NHS improvements are threatened by short-term waiting list targets and the scale of health service reform.

It believes the improvements are being put at risk partly because of the concentration on short-term waiting targets.

"NHS leaders are stretched keeping the show on the road now and have limited time for other improvement activities," it warned."

Mr Farrow has described the Trust's three-year plan as "risky" as the Trust already had an underlying deficit of £2.5 million.

He said the only way of achieving the plan would be to identify areas where costs could be cut while ensuring care in areas of clinical necessity.

"The Trust has a plan which indicates we will achieve the key NHS target for 2003-2004 but there is a great deal of risk," he said.

"In terms of the first two years we will have minimum staff expansion and we are going to have extra challenges with the new EU working time directive."

The CHI, set up three years ago, reports that overall national standards have led to better and more consistent care. But it said improvements were "patchy and inconsistent."

"Some parts of the NHS are not improving and may be getting worse. We are concerned that the improvement we see in the NHS is at risk," it warned.

The report said this was because of the scale of reform and a concentration on short-term waiting targets.

CHI Chairwoman Dame Deir-dre Hine said waiting times were an important part of patient care.

But she added: "If you concentrate solely on waiting times, the problem is that you can push other things into second place."

A Department of Health spokesman said the report made it clear there was much more work to be done to continue the good progress.

"That is exactly why we are giving the NHS the largest funding increases in its history, and much-needed reform to decentralise control and reward those who deliver results for patients," he said.