PATIENTS face a two-year wait before the £5.5 million of Assembly investment in Gwent's orthopaedic services pays off.
Health bosses predict that new operating theatres at St Woolos Hospital, Newport - allowing specialists to see thousands more outpatients and perform hundreds more joint replacements and other operations every year - will not open until late 2005.
NHS troubleshooter Professor Brian Edwards - who reviewed Gwent's orthopaedic services after increasing numbers of patients were forced to wait more than 18 months for surgery - said in January a scheme to boost orthopaedic capacity at St Woolos could be available within a year.
But that was based on using temporary theatres, and the scheme recently approved by the Assembly involves permanent facilities - so patients face a much longer wait.
The St Woolos project - two orthopaedic theatres, a 30-bed ward, post-operative and outpatient facilities, and staff - would mean more than 800 extra treatments and 2,000 more outpatients being handled every year.
Trust performance chief Allan Davies said: "It will be late 2005 before we can expect the first case to go through.
"It will be early next summer at the earliest for a start on building, and the most optimistic estimate is 12 months for building, but it will probably be nearer 15 months."
Pensioner Dorothy Meats, of Pontllanfraith, needs a hip replacement and suffers constant pain from chronic arthritis. Mrs Meats, 77, faces a wait of up to three years before seeing a consultant.
"I could then have to wait another 18 months for the operation after seeing the consultant," she added.
Funding for the St Woolos project was only confirmed last month - even though Gwent Healthcare Trust submitted its proposals for Assembly approval seven months ago.
An outline business case was submitted in mid-April, but the Assembly's insistence on the project meeting strict value-for-money criteria delayed final approval until November 4.
That case must now be amended to take into account recent agreements on future demand and capacity, and a full business case must be approved.
This will need agreement between the trust, the Assembly and Gwent's five Local Health Boards (LHBs) over running costs.
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