The  Accident & Emergency Departments in our district hospitals do a wonderful job and  will always remain a very necessary  essential facility for the  whole community. They  save many lives and  'heal' people  at the time of their  urgent need.  <p>

But  there is always a price to pay. To remain useful , effective and up-to-date, these units must be adequately staffed and resourced AND TO BE ONLY USED BY APPROPRIATE CLIENTELE.   Unfortunately  the latter is not always the case; many go there for  'minimal'  problems which could await a GP  appointment next day  or might even 'go away' spontaneously.   That said  it is also  true that  'major' problems are often 'undignosed  minor'  ones  warranting an expert assessment  but does it always have to be an immediate one?  <p>

Many small  casualty departments have been closed in recent years ; the reason being that advanced  medicine cannot often be safely delivered  everywhere.  Human lives are valuable and everything 'available' must be offered  but that is simply not practicable everywhere - people with expertise , equipments , laboratory backup etc are essential.<p>

The  recent surge may be due  to several reasons --  a)  changes in the contractual work of many GPs; b) increase in the number of frail and  dependent people without any available  care-giver; c) increase in the general expectation of the average consumer  and  easy availablity of the local hospital casualty  not costing anything on the spot!  etc  . This list can be broadened.  On top of everything , hospital beds have been  steadily diminishing  with the 'idea' that most things can be handled outside   - well it is  a good idea and NOT NEW  but to make it deliver  one needs an effective properly functioning  infrastructure with appropriately trained personnel , which  doesn't always  exist !<p>

The pressure on our  A & E  depts is enormous and the staff working there are on the verge of breaking point.  They are attempting to do their best under very difficult circumstances -- if the 'system' fails, it is not due to their incompetence or laziness -- we , as a society must appreciate this and  support them wholeheartedly  and  thank them profusely.