JANE Hutt is being coy about how much cash she will grant to Gwent next month to start an overhaul of orthopaedic services.

But thousands of patients will hope she is feeling generous - and so does orthopaedic surgeon Andy Grant.

Mr Grant, director of orthopaedics for Gwent Healthcare Trust, admits the service is "clearly failing the people of Gwent".

"We recognise the need for tighter management and other measures but these in themselves will not deliver waiting times targets," he said.

"If there is not an announcement of support on February 26, the service in Gwent will soon be in free-fall and will become an emergency only service very quickly."

It will be February 26 before the Assembly health minister announces details of extra funding and the service improvements she expects in return.

But the Edwards Report identifies around £8 million of potential investment to provide extra facilities at two Gwent hospitals:

Extra beds and the staff to run them at Nevill Hall Hospital, Abergavenny, to increase operations and outpatient appointments - £1m, with £2.2m running costs;

Demountable theatres and extra beds at St Woolos Hospital, Newport, with the same aims - £2-2.5m, with £3-3.5m running costs.

Both projects could be up and running within a year, possibly in as little as eight months. They would provide a huge boost to the service.

Nevill Hall could provide 600 more operations and 1,000 extra outpatient consultations a year, St Woolos 840 operations and 2,000 outpatient consultations a year. This extra capacity would soon begin to make inroads into waiting lists and waiting times. But it is not the whole picture.

The Edwards Report, says Ms Hutt, provides an opportunity to "change the face of orthopaedic care in Gwent."

But she has made it clear extra investment is not the only solution. Professor Edwards believes management of Gwent's orthopaedic services must be tightened up. Gwent Healthcare Trust, his report states, must also work more closely with the new Local Health Boards, GPs, and social services to ensure patients get a better deal.

Patients should be made more aware, he says, of the waiting times to see individual orthopaedic surgeons, and have the option of being referred by their GP to "the orthopaedic service" rather than a named consultant.

The trust is also being urged to develop closer relations with patients on inpatient lists, involving more contact especially immediately prior to admission. This, said Professor Edwards, will be "much appreciated" by patients.

Regular validation of inpatient and outpatient waiting lists is also needed, he says, so patients' conditions can be monitored more effectively and they can be taken off lists altogether if necessary, or offered alternatives, where appropriate, to seeing a consultant.

The Edwards Report also proposes a review of operating theatre practices at the Royal Gwent Hospital, and creation of an orthopaedics operations room run by a senior support team.

Ms Hutt is adopting a carrot-and-stick approach. More money will come to Gwent as a result of the Edwards Report - hardly surprising as having commissioned it, she cannot ignore its findings.

But she will insist on the NHS in Gwent sharpening its act to maximise the effectiveness of extra cash.

"Changes in the way patients are dealt with are vital. Unless they happen we would not be investing wisely," she said.

"This report can really change the face of orthopaedic care in Gwent, but it is not just up to me. The delivery has to be made here in Gwent.

"Unless everyone grasps this, it will be a wasted opportunity. There are a lot of things that have to be changed in Gwent and I believe lessons should be learned throughout Wales."

PICTURED: Surgeon Andrew Grant and his team perform a knee operation at the Royal Gwent Hospital.