Posted by: Tony Copperfield28 August 2012
‘So like, I waited for over two hours just to be told there was nuffink wrong wivvim,’ she said. And she wasn’t ’appy, obviously.
‘Clearly a case of “res ipsa loquituur”,’ I said.
‘What’s that, then? Is it a virus? They said it was a virus. How can it be a virus if there’s nuffink wrong wiv ’im? I’m not ’appy.’
I examined the child. He looked maybe a tiny bit dehydrated, but certainly not enough to meet my criteria for an A&E visit (so dehydrated he could be packaged and sold as ‘Tot Noodle’: simply add hot water, stir, and enjoy). Still, she wasn’t ’appy.
‘I’m sorry you’re not ’appy. Res ipsa loquituur is Latin for “The facts speak for themselves...” You did, indeed, wait for two hours and there is, indeed, nothing wrong with your delightful child. See how he’s throwing himself into the tricky task of dismantling my contaminated sharps bin.’
‘Well, he had diarrhoea. I spoke to the GP on duty. She just said that it was nuffink to worry about and to make sure he drank lots. I wasn’t satisfied so I took him up the ’ospital. I wanted some proper tests done.’
While the outward Doctor Copp was going through the loose motions, my higher cerebral centres were remembering that as far as the local PCT is concerned, her visit to A&E with a kid who didn’t need to be there was somehow my fault.
‘According to the notes, the duty doctor offered to see him later today if he didn’t improve. In fact it seems she pencilled him in for five-thirty.’
‘Well I wasn’t going to wait that long, was I? If you go to A&E they’ve got to sort you out wivvin four hours. I read it in the paper. Anyway, suppose it had been sumfink serious?’
It patently wasn’t. But there’s the issue. Although we provide the sort of easy access for trivia you might expect to have even the most hardened Patients Who Know Their Rights groups wetting themselves with joy, offering to see a kid who doesn’t need to be seen before close of play the same day isn’t, apparently, enough to satisfy the wishes of our demanding 21st century, 24-7 clientele.
We have a bunch of doctors doing their best to sort the wheat from the chaff, although panning for specks of gold in a river of slurry might be a better metaphor. But the local A&E has an Always and Everyone instant access triviatrics service on offer. How are we supposed to persuade people not to use it?
A GP on duty spends a good deal of time deflecting patients, redirecting them to a more appropriate service or suggesting a more sensible course of action than ringing the surgery every time someone has a sniffle or a runny poo. But in hospital, time, it seems, is of the essence.
So I want A&E to change the way it operates. Bring back the queue. Have someone senior triaging the walking, or toddling, wounded. If they want to hang around, let them. Next time I want to hear, ‘So like, I waited for over seven hours just to be told there was nuffink wrong...’
She won’t be ’appy.
But I will be.
Dr Tony Copperfield is a GP in Essex