• Anaesthesia, general

Hospitals in England and Wales have been grappling with the UK government's 4-h target for emergency departments (EDs) for many years; the pluses and minuses associated with it are well documented elsewhere and will not be restated here. Emergency doctors in Australia and New Zealand have watched events in the UK unfold with an almost morbid fascination, wondering if such a target will ever be introduced here. Well, it has now arrived.

The Australasian College for Emergency Medicine (ACEM) has been and is a lead agency in researching, auditing and highlighting to state and national governments the clinical, professional and fiscal problems that arise out of ED overcrowding, access (bed) block and ambulance ramping, problems that have been a scourge for hospitals and EDs in Australasia for many years. New Zealand and the Australian states and territories have each responded differently to this lobbying and the data the ACEM gives them. It takes a long time to move mountains—but they …