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Twenty-four hours in A&E is now “no longer a documentary”, leading medics have warned, as figures show almost 400,000 patients spent a day or more in an emergency department in England last year.

The Royal College of Emergency Medicine (RCEM) said the very long waits are a “matter of national shame”.

Figures uncovered by the college and shared with the PA news agency show 399,908 people waited 24 hours or more in an emergency department in England in 2022-23.

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The college warned there could be a similar situation this year, with Dr Adrian Boyle, its president, cautioning that patients are coming to avoidable harm as a result of long waits.

“We know that long stays in emergency departments are harmful,” Dr Boyle said.

“There is good scientific data that shows that once people spend more than about six hours, and they need to be admitted into hospital, actually their mortality starts to get worse.

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“I think it should be a matter of national shame that we have these very long waits for admitted patients.”

He said people caught up in the long waits are “often elderly and vulnerable”.

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Political parties urged to end overcrowding

The RCEM has made a number of calls to political parties in its general manifesto, including:

• To end overcrowding in emergency departments, including by ensuring there are enough hospital beds to prevent people being stuck in emergency departments when they need a bed on a ward.

• More funding for social care to prevent a system where people who no longer need hospital care can be discharged when ready.

• More emergency medicine staff to deliver “safe and sustainable care” and for more work to retain current staff.

• More data to be published on hospital performance.

• A call to “resource the NHS to ensure the emergency system can provide equitable care to all”.

Cardiac arrest patients should be taken to their closest emergency department

Record number attend A&E

A record number of patients attended A&E in England in 2022-33, 25.3 million, up 4% from the previous year, according to figures released last week.

The data also shows 71% of people spent four hours or less in A&E in 2022-23.

The NHS recovery plan sets a target of March 2024 for 76% of patients attending A&E to be admitted, transferred or discharged within four hours, with further improvements expected the following year.

An NHS England spokesperson said: “This data relates to last year and winter, when services were facing record demand, industrial action and a twindemic of COVID and flu, but since we published our urgent and emergency care recovery plan in January we have seen significant improvements.

“Thanks to the hard work of NHS staff Category 2 ambulance response times are now an hour faster than in December, A&E four-hour performance is up from 69% to 73%, and the proportion of patients waiting 12 hours in A&E is down a sixth.

“We know there is more to do, which is why we set out our winter plans earlier than ever before this year, expanding care ‘traffic control’ centres, delivering additional ambulance hours and extra beds to boost capacity and reduce long waits for patients, and other initiatives like same day emergency care units and virtual wards which can mean patients are able to get the care they need without an unnecessary trip to an emergency department – this is better for them, and means A&E staff can continue to prioritise those with the most urgent clinical need.”

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Panama’s capital to accept crypto for taxes, municipal fees

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<div>Panama's capital to accept crypto for taxes, municipal fees</div>

<div>Panama's capital to accept crypto for taxes, municipal fees</div>

Panama’s capital city will accept cryptocurrency payments for taxes and municipal fees, including bus tickets and permits, Panama City mayor Mayer Mizrachi announced on April 15, joining a growing list of jurisdictions globally that have voted to accept such payments.

Panama City will begin accepting Bitcoin (BTC), Ether (ETH), Circle’s USDC (USDC), and Tether’s USDt (USDT) stablecoin for payment once the crypto-to-fiat payment rails are established, Mizrachi posted on the X platform.

Mizrachi said previous administrations attempted to push through similar legislation but failed to overcome stipulations requiring the local government to accept funds denominated in US dollars.

In a translated statement, the Panama City mayor said that the local government partnered with a bank that will immediately convert any digital assets received into US dollars, allowing the municipality to accept crypto without introducing new legislation.

Panama City joins a growing list of global jurisdictions on the municipal and state level accepting cryptocurrency payments for taxes, exploring Bitcoin strategic reserves to protect public treasuries from inflation and passing pro-crypto policies to attract investment.

Taxes, Panama, Bitcoin Adoption
Source: Mayer Mizrachi

Related: New York bill proposes legalizing Bitcoin, crypto for state payments

Municipalities and states embrace digital assets

Several municipalities and territories around the globe already accept crypto for tax payments or are exploring various implementations of blockchain technology for government spending.

The US state of Colorado started accepting crypto payments for taxes in September 2022. Much like Panama City said it will do, Colorado immediately converts the crypto to fiat.

In December 2023, the city of Lugano, Switzerland, announced taxes and city fees could be paid in Bitcoin, which was one of the developments that earned it the reputation of being a globally recognized Bitcoin city.

The city council of Vancouver, Canada, passed a motion to become “Bitcoin-friendly city” in December 2024. As part of that motion, the Vancouver local government will explore integrating BTC into the financial system, including tax payments.

North Carolina lawmaker Neal Jackson introduced legislation titled “The North Carolina Digital Asset Freedom Act” on April 10. If passed, the bill will recognize cryptocurrencies as an official form of payment that can be used to pay taxes.

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Fed’s Powell reasserts support for stablecoin legislation

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<div>Fed's Powell reasserts support for stablecoin legislation</div>

<div>Fed's Powell reasserts support for stablecoin legislation</div>

As digital assets gain mainstream adoption, establishing a legal framework for stablecoins is a “good idea,” said US Federal Reserve Chair Jerome Powell.

In an April 16 panel at the Economic Club of Chicago, Powell commented on the evolution of the cryptocurrency industry, which has delivered a consumer use case that “could have wide appeal” following a difficult “wave of failures and frauds,” he said.

Fed's Powell reasserts support for stablecoin legislation

Powell delivers remarks at the Economic Club of Chicago. Source: Bloomberg Television

During crypto’s difficult years, which culminated in 2022 and 2023 with several high-profile business failures, the Fed “worked with Congress to try to get a […] legal framework for stablecoins, which would have been a nice place to start,” said Powell. “We were not successful.”

“I think that the climate is changing and you’re moving into more mainstreaming of that whole sector, so Congress is again looking […] at a legal framework for stablecoins,” he said. 

“Depending on what’s in it, that’s a good idea. We need that. There isn’t one now,” said Powell.

This isn’t the first time Powell acknowledged the need for stablecoin legislation. In June 2023, the Fed boss told the House Financial Services Committee that stablecoins were “a form of money” that requires “robust” federal oversight.

Related: Stablecoins are the best way to ensure US dollar dominance — Web3 CEO

Support for stablecoin legislation is growing

The election of US President Donald Trump has ushered in a new era of pro-crypto appointments and policy shifts that could make America a digital asset superpower

Washington’s formal embrace of cryptocurrency began earlier this year when Trump established the President’s Council of Advisers on Digital Assets, with Bo Hines as the executive director. 

Hines told a digital asset summit in New York last month that a comprehensive stablecoin bill was a top priority for the current administration. After the Senate Banking Committee passed the GENIUS Act, a final stablecoin bill could arrive at the president’s desk “in the next two months,” said Hines.

Fed's Powell reasserts support for stablecoin legislation

Bo Hines (right) speaks of “imminent” stablecoin legislation at the Digital Asset Summit on March 18. Source: Cointelegraph

Stablecoins pegged to the US dollar are by far the most popular tokens used for remittances and cryptocurrency trading.

The combined value of all stablecoins is currently $227 billion, according to RWA.xyz. The dollar-pegged USDC (USDC) and USDt (USDT) account for more than 88% of the total market. 

Magazine: Unstablecoins: Depegging, bank runs and other risks loom

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Court grants 60-day pause of SEC, Ripple appeals case

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Court grants 60-day pause of SEC, Ripple appeals case

Court grants 60-day pause of SEC, Ripple appeals case

An appellate court has granted a joint request from Ripple Labs and the Securities and Exchange Commission (SEC) to pause an appeal in a 2020 SEC case against Ripple amid settlement negotiations.

In an April 16 filing in the US Court of Appeals for the Second Circuit, the court approved a joint SEC-Ripple motion to hold the appeal in abeyance — temporarily pausing the case — for 60 days. As part of the order, the SEC is expected to file a status report by June 15.

Law, Ripple, SEC, Court
April 16 order approving a motion to hold an appeal in abeyance. Source: PACER

The SEC’s case against Ripple and its executives, filed in December 2020, was expected to begin winding down after Ripple CEO Brad Garlinghouse announced on March 19 that the commission would be dropping its appeal against the blockchain firm. A federal court found Ripple liable for $125 million in an August ruling, resulting in both the SEC and blockchain firm filing an appeal and cross-appeal, respectively.

However, once US President Donald Trump took office and leadership of the SEC moved from former chair Gary Gensler to acting chair Mark Uyeda, the commission began dropping multiple enforcement cases against crypto firms in a seeming political shift. Ripple pledged $5 million in XRP to Trump’s inauguration fund, and Garlinghouse and chief legal officer Stuart Alderoty attended events supporting the US president.

Related: SEC dropping Ripple case is ‘final exclamation mark’ that XRP is not a security — John Deaton

Despite support for the end of the case coming from both Ripple and the SEC, the August 2024 judgment and appellate cases leave some legal entanglements. Alderoty said in March that Ripple would drop its cross-appeal with the SEC and receive a roughly $75 million refund from the lower court judgment. It’s unclear what else may result from negotiations over a settlement in appellate court.

New leadership at SEC incoming

Acting chair Uyeda is expected to step down following the US Senate confirming Paul Atkins as SEC chair on April 9.

During his confirmation hearings, lawmakers questioned Atkins about his ties to crypto, which could create conflicts of interest in his role regulating the industry. In financial disclosures, Atkins stated he had millions of dollars in assets through stakes in crypto firms, including Securitize, Pontoro and Patomak.

Magazine: SEC’s U-turn on crypto leaves key questions unanswered

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