It really seems to be a case of same sh** different city. The lack of an effective system to move 'bed blockers' on to appropriate care is one big issue. The other, at least her in Melbourne, Australia, is the lack of that appropriate care. With an ageing population that is living longer and longer, we are in a crisis situation. The ripple effect to every other part of the health system is a huge challenge and one that isn't being dealt with very effectively at the moment. Our Ambulance Service has avoided direct blame for high volume 000 calls as a contributing factor - for the moment - but the howls have begun at longer response times (attendance delays) directly related to triage and handover delays at hospitals which have increased from 15-20mins previously to upward of 30mins as the current norm, due, in part to bed blocking.