Consign four-hour A&E rule to history
HAVING just spent a month in New Zealand, I was disheartened, but not surprised, to see the fourhour rule is still alive and well in Scottish emergency departments (“Ward wait times improve but target still elusive”, The Herald, April 4). This recurring report always has the effect of depicting the emergency department as a dressing station at Passchendaele; it’s a disaster to go there but if you must, get yourself out as fast as possible.
While in NZ I visited my old stomping ground, the emergency department of Middlemore Hospital in South Auckland. It had: 160 beds with oxygen and suction; six resuscitation rooms; a 22-bed 24-hour short stay unit; 105,000 patients per annum (including 23 per cent paediatrics); 24 emergency medicine consultants; 18 registrars; 14 junior doctors; Six further senior doctors or college fellows; 6.5 clinical nurse specialists; 12 charge nurses;120 staff nurses.
In other words, the emergency department is not merely a triage station, but is the hub of the hospital’s acute service. And we keep banging on about the four-hour rule. Heaven help us.
Dr Hamish Maclaren,
1 Grays Loan, Thornhill, Stirling.
LETTERS from Graham Watt and John Black (April 3) stand in marked contrast. Evidence and experience are clearly expressed in the former and frustration is revealed in the latter.
General practice remains the bedrock of the NHS and the out-ofhours service, staffed by nurses and GPS, meets a real need. NHS24 as call-handler is well placed to decide if ambulance or paramedic are the most appropriate response.
While across the board increase in funding acknowledges that practices’ doors are open to all, Professor Watt makes a vital case for an additional health boardemployed workforce to be team members in areas of highest deprivation. The new contract challenges GPS to lead effectively and address unmet need as well as the emphasis on serving frail older people in their homes.
I and many others will be watching developments as the contract unfolds.
Philip Gaskell,
General practitioner,
Woodlands Lodge, Buchanan Castle Estate, Drymen. MY wife and I have received superb cancer and cardiac treatment from Ninewells Hospital.
While the donation form gives the trustees fairly wide discretion, we would be disappointed to say the least if Tayside Health Fund diverted our subsequent donation (on which they were entitled to claim gift-aid from HMRC) to help fund a £2.7million shortfall in what is surely core NHS expenditure such as a computer system (“Failing NHS board raided £2.7m from charity fund”, The Herald, April 4)
This seems akin to Harold
Wilson and Alf Robens grabbing some of the Aberfan Survivors’ Fund in the 1960s to pay for safety measures at other coal-tips.
John Birkett,
12 Horseleys Park,
St Andrews.