A year is a long time in politics; sometimes in health a year can seem even longer than that.

In 2010, we used this editorial space to report on the introduction of time-based emergency targets in Australasia—4 h in Australia and 6 h in New Zealand.1 We offered to provide occasional updates, believing they are of interest to international readers as well as local ones. Well, there is a striking development in Australia with the government recently announcing that the 4-hour emergency target threshold will be lowered from 95% to 90%, to be reached by 2015.2

Why did the government change its mind? Simple really—it decided to consult people (I won't use the hackneyed phrase ‘key stakeholders’) and then (the crucial step) listen to them. A National Expert Panel, a mixture of clinicians and managers, convened in the first half of 2011 managed the consultation …