It is, of course, regrettable that it should have to exist at all, but given the ‘thousand natural shocks that flesh is heir to’, it is a fundamental and indispensable part of our health service.

However, as well as being grateful for the care and treatment that is available at Accident and Emergency, Islanders should remember exactly what the department is designed to achieve. It is for urgently needed medical attention and not a place for what might be described as routine maintenance.

It is, unfortunately, clear that large numbers of people regard A&E as a drop-in centre for the diagnosis and treatment of non-emergency conditions. In other words, they use the department as an alternative to their doctor’s surgery, putting excessive and unwelcome pressure on a service that is, at the best of times, hard pressed.

But we must look beyond the unacceptable burden that is being imposed on A&E and the knock-on financial burden on Health and Social Services.

The question to be asked is this – why are so many people taking the A&E route rather than consulting a general practitioner?

In some cases the sheer convenience of being able to turn up without making an appointment could be a factor. In others the opportunity to save money by seeking totally free treatment will no doubt be providing the impetus.

It must be made clear to the public that these reasons for attending are simply not good enough and, where trivial non-urgent conditions are concerned, requiring payment for services rendered could well get the message across very quickly.

But there is another scenario that cannot be ignored. Some people will be using A&E for routine treatment because even the subsidised cost of going to the doctor is prohibitive. Locking this category of Islander out of easy access to medical care would lead to as many, if not more problems, as it would solve.

Faulty appreciation of what A&E is all about and consequent budgetary problems are one side of the coin, but the other side, which could carry information about the impact of these recessionary times on some Islanders’ ability to pay for medical treatment, must also be examined.

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