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Hey - don't go there - come over here instead! 4 day working week...Mediterranean climate...5 bedroom houses for STG150 000...advertising shortly for consultants and staff grades... Our summer is better than their summer, too. Fiona. Dr Fiona Wallace MB BS MA Director ED Mersey Community Hospital Latrobe Tasmania Australia [log in to unmask] [log in to unmask] -----Original Message----- From: Accident and Emergency Academic List [mailto:[log in to unmask]] On Behalf Of Derek Sage Sent: Wednesday, 22 October 2008 11:09 PM To: [log in to unmask] Subject: Re: 3hr stretch target v 4hr target Treating a backlog in the emergency department by having a time target only replaces one problem with another and destroys the specialty of emergency medicine. A patient's temperature is a marker of something being wrong and we accept that treating a figure (temperature/fever or time) is not the same as fixing the underlying problem. In fact it can be dangerous to assume that fixing the target is a 'healthy outcome'. It is an indicator and politicians and some clinicians have lost sight of this fact. If the temperature is raised or the time in ED is excessive look for the cause and fix it/them and do not assume fixing the time equates to fixing the cause. Yes it has given the ED more resources and 'power' but at what cost. The dumping of 'out of hours' work by GPs and the 4 hour target will suck the UK tax payers money up for no real health gains- only political ones. And now that the UK taxes are bailing out banks, the UK can ill afford it! In New Zealand we are not neurotic and it is so much better a place to live and work. All you guys in the UK should try it. Being from the UK and having 'jumped ships' I can say as a matter of fact. If you are interested in coming to NZ I will be happy to assist (anywhere here is better than damp, grey, overcrowded, violent, drunken Britain) Enjoy your winter in the UK (-Our winter was better than your summer) -Derek Sage 'Specialist' in Emergency Medicine Tauranga Hospital Tauranga, Bay of Plenty NZ ----- Original Message ----- From: "Adrian Kerner" <[log in to unmask]> To: <[log in to unmask]> Sent: Wednesday, October 22, 2008 11:52 PM Subject: Re: 3hr stretch target v 4hr target I am so pleased I do not have to deal with all this political [small p] stuff any more! I can now sort patients out; investigate and manage appropriately without worring about a clock!! I'm in New Zealand [3/12] and the care is pretty good. Yes, targets have been great to focus on what is done, but what has become of the Emergency Care doctor? You have become sign posts and sold out to a little 'p'. Best wishes from down under....enjoying the warmth and cosy life style....feel the air...... Adrian Kerner 'Specialist' in Emergency Medicine North Shore Hospital Auckland NZ