The latest report into the MSG's performance shows increased demand in the health sector and inadequate resources to deal with the pressure.
The Key Performance Indicator report is an assessment of the contract between the States and the MSG and is published annually.
On the positive side, the inpatient waiting list has decreased by a fifth between 2023 and 24.
The secondary healthcare provider is meeting its referral target 62% of the time, meaning patients sent to them by their GP are seen within eight weeks. Conversely this means nearly 38% are having to wait longer.
Dr Steve Evans is the chair of the MSG and apologises for those not seen promptly:
" I realise it can be an anxious time but I'd like to reassure people that they are judged on their clinical needs, so if things are urgent then they're dealt with appropriately."
Orthopaedics and gastroenterology have the longest waiting lists but a record 488 orthopaedic procedures took place at the PEH last year.
Medical Director Dr Peter Rabey says the new De Havilland Ward allowed 26 more patients to be seen than the year before, but 820 remain on the waiting list.
He says increasing demand means they need more theatre space, or people will have to accept delays to surgery:
"One orthopaedic theatre is being used all the time.
We need Phase Two (of the PEH modernisation) which will provide another operating theatre and this will allow us to make a game changing step up in the number of orthopaedic operations, so we're doing everything with what we have got."
12 beds in the PEH are consistently filled with patients who could have been discharged and health bosses say bed blocking leads to surgery being postponed and longer waiting times.
Director Dr Peter Rabey says the sector needs resources:
"We need more care workers, these are people who are hard to recruit as they find accommodation in Guernsey very expensive, and we need more care and residential homes in Guernsey."
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