In 1975, this was the situation in Temple Street in Dublin when I worked there as a junior doctor. Plus Ca change!

Parents ‘bypassing GPs’ for non-urgent child treatment

By Michelle Roberts Health reporter, BBC News

            Fever was one of the 10 common problems parents sought help for

Rising numbers of parents are bypassing GPs and taking children to hospitals’ A&E departments for medical treatment, researchers say.
Attendance for 10 common medical problems, including fever and rash, rose 42% in a decade at Nottingham’s Queen’s Medical Centre, they said.
Difficulty accessing out-of-hours GP care may be to blame, they say in the Emergency Medicine Journal.

The government said it was developing a strategy for out-of-hours care.
It said it wanted to deliver high quality, urgent care services around the clock.

During the past 10 years, the way the NHS provides care for common medical problems at night and at weekends has changed.

GPs are no longer obliged to provide out-of-hours care and advice to worried parents, with large private companies now generally contracted to provide this instead.

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We need to have more integrated care rather than the confusing, expensive system we have currently”

John Heyworth President of the College of Emergency Medicine

John Heyworth, president of the College of Emergency Medicine, says this has caused some confusion for patients and, in some instances, has made it harder for them to access care.

“Parents have found in the last few years that accessing primary care is more difficult than previously.”

He said more and more patients were turning to A&E departments.

“We’ve been recognising this. Attendances are going up by between eight and nine per cent a year.”


In the study spanning a decade, the number of patients attending the children’s emergency department at Queen’s remained similar, but the number attending with common medical problems had risen by 42%.
A total of 39,394 children were seen in 2007-8, of whom 14,724 had medical problems. This compared with 38,982 children seen overall in 1997, of whom 10,369 had medical problems.

Dr Heyworth said the findings highlighted the shortcomings in the way services were currently organised.

He said: “We need to have more integrated care rather than the confusing, expensive system we have currently.

“It is very patchy and the public are frankly getting a raw deal.”

The college is calling for GP services to be co-located next to A&E departments to deal with people who need to see a GP.

A Department of Health spokesperson said: “Our vision is to replace the ad-hoc, uncoordinated system that has developed over more than a decade, and has been characterised by poor quality and too much variation.”

Meanwhile, a study in the same journal reveals most UK hospital A&E departments are ill-equipped to treat children with serious head injuries.

A confidential enquiry found 87% of hospitals in England, Wales, Northern Ireland and the Channel Islands and Isle of Man could not care for a critically ill child on site.

The authors say transferring these sick children some miles to other hospitals could harm their survival chances as treatment delays can prove fatal.

Around 210,000 children with head injuries attend hospital every year, and around 34,500 are admitted. A few children with serious head injuries will require emergency surgery and intensive care.

But the way services are currently organised – with centralised intensive care services – means some patients need to be transferred to get the care they need.