The number of patients facing long waits for NHS care in Wales has risen, according to new figures.
Waiting lists for NHS treatment have grown in Wales
The statistics include 465 people who declined an offer to travel elsewhere for treatment.
The Conservatives called for an explanation of why patients are turning down the Labour-run assembly government's "second offer" option.
The assembly government said it was focused on cutting waiting times rather than waiting lists.
The latest monthly figures show the number of patients waiting more than 18 months for an in-patient or day case appointment rose by 2.5% in July to 1,483.
But 465 patients had been offered treatment under the terms of the second offer scheme but had declined.
If those people were excluded, the figures would show a 9.9% decrease, according to the assembly government.
The figures also showed that the number of patients waiting over 18 months for a first outpatient appointment has also risen, by 1.1 % to 7,186.
There are still no patients waiting more than 10 months for cardiac surgery.
Conservative health spokesman Jonathan Morgan said he wanted to know why patients were declining second offers of treatment - a scheme offering treatment elsewhere in Wales or in England.
He said: "Many patients who have been waiting more than 18 months for treatment are very often unable to travel.
"Second offers of treatment often happen in England meaning both the patient and relatives must travel considerable distances, sometimes for many months."
Plaid Cymru health spokesman Rhodri Glyn Thomas said the figures showed Labour was "nowhere near" reaching its waiting list targets.
He said: "I regularly receive letters from my constituents describing the long waits they have for hospital treatment."
The assembly government said: "It is the established policy of the Welsh Assembly Government to focus on waiting times and not waiting lists.
"The number of people waiting matters less than the length of time, which any patient has to wait for treatment.
"Since July last year there has been a major reduction on the number of patients waiting more than 18 months for in-patient or day case surgery. It has fallen by nearly 3,000 to 1,483.
"Of those patients waiting over 18 months for their treatment, 465 have elected to remain to have their treatment at their local hospital."