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Tip of the iceberg? The four-hour standard
  1. J Bethel
  1. University of Wolverhampton and Walsall Hospitals NHS Trust, Dudley, UK
  1. Correspondence to James Bethel, University of Wolverhampton and Walsall Hospitals NHS Trust 16 Gatacre Street, Lower Gornal, Dudley, West Midlands DY3 2NZ, UK; James.Bethel{at}

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I read with great interest your work summarising the reports concerning the calamitous events at Mid Staffordshire hospital recently. In your concluding piece, you state that current health ministers and the government at large may be concerned that the events at Mid Staffordshire represent the tip of an iceberg rather than a freakish idiosyncrasy. In spring of 2008, the Royal …

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  • This was written in response to Professor Geoffrey Hughes editorial concerning the recent review of emergency services at Mid-Staffordshire NHS Trust.

  • Competing interests None.

  • Provenance and peer review Not commissioned; not externally peer reviewed.