Read how well-meaning incentives are being subverted:

Governments are very good at establishing perverse incentives without realizing it. And so it was with the NHS. The 4-hour rule is simple. A patient must be seen within 4 fours of admission. If too many patients are not seen in that time the health service could lose funding. Of course the ability to see patients that quickly is not increased by the rule. Instead the local hospitals have incentives to act in very strange ways.

If you know you can’t see a patient in emergency care for at least six hours, but you are required to see them within four hours of admission, then the easiest way to solve the problem is to delay admission for an additional two hours.