Opinion: Accident and emergency should be for accidents and emergencies

A&E used to be used for accidents and emergencies only - now it seems people use it for every little

A&E used to be used for accidents and emergencies only - now it seems people use it for every little ailment. - Credit: PA

When I was growing up, you only bothered front-line A&E staff if you needed stitching, reviving, urgent surgery or a limb set in a cast – and only the latter if your bones were protruding so bad the entire arm or leg needed resetting.

Everything else was a 'wait and see' case – wait until the next day, and nearly always, however bad the ailment looked or felt the night before, it felt better in the morning.

For anything less than a life-or-death or potentially life-changing injury, you'd feel a fraud to waste the time of staff trained to save lives, not slap calamine on sunburn caused by stupidity.

In those days ambulances weren't queued up with their cargo of acute cases because A&E was too busy.

Then, emergency staff's expertise and role – or casualty, as we called it then – were respected for the rare and only desperate times a family would need them. People knew the difference between emergency, urgent and important.


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But then we were prepared to wait. Today, no one is willing to wait for anything and wants everything dealt with and put right immediately, when they want it – however minor their issue – to suit their own schedule. Because they pay their taxes and that is their right.

Like credit cards, A&E is an instant solution to a problem. Instant is our way of life.

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This week a former A&E consultant summed up the root of the crisis A&E staff valiantly face and conquer every day: A&E departments are treated like a 24-hour Tesco. Open all hours for convenience.

People who rock up to triage with a minor burn, headache or earache then grumble they have to wait are beyond selfish, thoughtless and even ignorance. Dr Karim Hassan, who worked at Royal Bournemouth Hospital for almost 20 years while admissions almost doubled, accused people of using the department inappropriately.

Those who can't get an appointment at GP for a sport injury but want to get back on the rugby pitch at the weekend, people wanting fast-track antibiotics, non-emergency aches, pains and grazes.

On the same day, the East of England Ambulance Service revealed the time wasting and hoax calls they received among the 2,500 calls a day as it launched its Right Call campaign.

Calls this year included a woman who had stuffed herself with too much takeaway and a woman whose dog was vomiting blood.

But it's terrible, people moan, to have to wait four hours after banging a thumbnail with a hammer... oblivious to the desperate CPR being administered just yards away by frazzled staff saving lives this minute and dealing with abusive drunks the next.

I'm all for turning people away if they don't meet the emergency criteria – to send them packing to a walk-in centre or GP surgery the next day. That's probably why I'm not in the caring profession.

NHS people are just too nice. It will never happen. Even if it means getting abused at worst, and whined at, at best.

A re-education programme is needed to teach the difference between emergency and urgent if A&E departments are to survive.

A first step would be screens in the waiting room to live stream the queue of ambulances outside and lists of serious and life threatening conditions staff are dealing with while they wait with a sprained wrist, ramming home the reality of real serious illness – the heart attacks, traffic accidents, strokes and brain haemorrhages that need instant expert care or people will die.

Before every trip to A&E, everyone needs to look in the mirror and ask: Am I going to die? Will I be left with a life changing condition if I don't go to hospital now?

If the answer is 'no' to both of them, then skedaddle to your GP the next day.

A long-term solution needs a massive change in GP practice and attitudes, with walk-in consultations rather than an appointment system. We wait weeks for appointments and the old out-of-hours service is all but gone.

Until this happens, the A&E crisis will just get worse.

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