An NHS Fife boss has accused the Scottish Government of being in denial over accident and emergency waiting time targets.
Operational division chairman David Stewart said the target of at least 98% of patients waiting no longer than four hours at accident and emergency (A&E) was unrealistic during the winter months.
However, medical director Dr Gordon Birnie said the target was necessary to protect patient safety.
Mr Stewart said: “When I see the demand in the system, particularly during the winter, I have to say I’m arriving at the conclusion that any Government that seriously expects the A&E four-hour target to be met during the winter is in denial about what’s happening in the NHS, not just here but across Scotland because every board is struggling to meet this.
“The Government needs to look at that target and maybe flex it during the winter.”
Figures for last September indicated that NHS Fife was surpassing the 98% target, after the figure plummeted to around 83% at the end of 2011.
In his report to Wednesday’s operational division committee meeting at Victoria Hospital in Kirkcaldy, Dr Birnie said waiting times had deteriorated again, with some patients waiting more than 12 hours.
Mr Stewart added: “The system is under very high pressure. Hospitals have to deal with huge numbers of patients, which is not unusual at this time of year, but patients coming in tend to be older and sicker.
“I’d like to say a big thanks to staff who have been working extremely hard under great pressure nursing staff, doctors and the often maligned group of staff that is managers.
“I’m quietly confident we will recover faster than we have before because of what we’ve been doing over the last year.”
Dr Birnie dismissed the idea Scottish Government targets should be “flexed” but echoed Mr Stewart in acknowledging the hard work of staff to turn things around.
He said: “The thing with Scottish Government targets is that they are clearly linked to patient safety. I think we have to struggle to meet the target. Again we have experienced the usual difficulty in a system which is very finely balanced.”
A lack of available beds is the main reason patients are kept waiting in A&E.
Although Fife has not been badly hit by norovirus, there has been the usual increase in admissions expected during winter, with many affected by respiratory infections.
Dr Birnie said NHS Fife’s response had included making more beds available in three wards, moving elderly patients awaiting care packages to respite beds, and moving patients with dementia to psychiatric units.
Meanwhile, non-emergency surgery was cancelled for two days over January 8 and 9 as hospitals struggled to cope with a backlog of patients.
The medical director said the decision to cancel non-emergency surgery for two days was “prudent” given the lack of beds available at the time.
Director of clinical delivery Andrea Wilson said NHS Fife’s performance towards the 18 week target for referral to treatment was also a cause for concern.
The Scottish Government target requires 90% of patients to wait no longer than 18 weeks from referral to treatment.
Last year NHS Fife was achieving a figure of around 95%. By November that had dropped off but it was still above 90%.