Published: 30/01/2003, Volume II3, No. 5840 Page 4

The government target for 100 per cent of accident and emergency arrivals to wait less than four hours for admission, treatment or discharge by March 2004 is unrealistic and unachievable, according to emergency access czar Professor Sir George Alberti.

In an interview published in HSJ this week, he said: 'I did not actually set that target [and] I have never been a great believer in 100 per cent targets because I do not think you can ever achieve them.'

He said that treating 'well over 90 per cent of minors [injuries] in under four hours' should be achieved, but 'the problems come with majors [injuries] where you need the right beds and I do not know whether we have enough staff to achieve that'.

Sir George stressed that improving the quality and efficiency of emergency care in the long term was more fundamental than targets. He also floated the idea of devolving budgets to 'effectively have an emergency care trust' or network linking different parts of the local health economy. One option would be to give emergency care a budget which would work across a sector: 'It is about focusing funding on a system of care rather than an institution, and it is something we talk about in chronic disease management more and more.'