Fears have been raised that waiting lists for appointments in Northern Ireland hospitals are spiralling out of control.
No patient in Northern Ireland is supposed to wait more than 15 weeks for an outpatient appointment, according to government targets.
But as the crisis in our health service deepens it has emerged that more than 40,000 people have been waiting almost four months just to get a first appointment.
The figure has quadrupled from last year, leading to fears that as savage health cuts are introduced, waiting lists will continue to rise.
The latest statistics reveal:
Former Health Minister Michael McGimpsey warned urgent action was needed to address the growing waiting lists before they "spiral" even more.
"It is spiralling, clearly spiralling," the Ulster Unionist MLA said.
"I'm concerned that the department has not got adequate control and know-how to address it. Because if they can't, things will deteriorate and spiral out of control."
It comes after the number of patients waiting 12 hours for emergency care in Northern Ireland jumped by 550% in three months. It jumped from 40 patients to 260 in September.
The Royal Victoria Hospital A&E was highlighted in the report, described as having a "notable decline" during the period with the number of patients waiting half-a-day rising from 36 to 139 in September.
Now there are now 20,328 waiting for first outpatient appointments for general surgery in Northern Ireland with 5,323 having waited over 15 weeks.
Meanwhile, there were 16,084 waiting for a consultation with an Ear Nose and Throat specialist and 3,826 waiting over 15 weeks.
Almost 13,000 women are waiting for a gynaecology appointment and 11,599 for a first dermatology consultation.
A DHSSPS spokeswoman last night said acute hospital services were continuing to face "considerable demand".
In 2013/14 there were more than 1.56 million outpatient attendances at consultant-led services; 611,000 hospital admissions and 727,000 attendances at emergency departments.
"It is essential that the health system is able to respond to and manage this demand - a situation which is becoming increasingly difficult within the confines of the current financial position."
It added that it was "disappointing" waiting time standards were not being maintained.
"It is regrettable that some patients are waiting longer for assessment and treatment; however a majority of patients are being seen within the target waiting times," the spokeswoman said.
"As indicated in the Health Minister's statement of October 30, the scale of the financial challenge in 2014/15 means that even with additional funding through the June and October Monitoring Rounds, there will still be consequences for the provision of health and social care services.
"The minister has said that it will simply not be possible to maintain current levels of service provision in the absence of all the required funding.
"The minister is investing £14m of the June and October Monitoring Round funding in elective care. This is much less than the HSC needs to meet the current demand and will inevitably have an impact on waiting times for elective assessment and treatment, which is regrettable."