Casualty Departments

There have been considerable changes in every branch of medicine since the in' ception of the Health Act, and in no branch is this more obvious than in the casualty departments of our hospitals throughout the country. There are many reasons changes and some of the main ones are discussed under three main headings. Firstly the public have changed in their attitude to the hospitals. The nearby in' stitution is no longer their hospital in which they take a pride and for which the) organize collections and fairs. It is now a part of the National Health Service and tn doctors and nurses who work there are State employees. Since it is no longer the'f hospital but a government responsibility they have little respect for it. Since they have no direct financial responsibility or interest, it is a concern in which the bf* should always be available, no matter what it costs. Many, of course, believe that major portion of their weekly contributions under the National Health scheme directed to the hospitals and doctors. For this reason they do not see why there shou be any need for economy in either equipment or personnel. The general public no regard the casualty department as a convenience to be employed at will, and to ^ criticized freely. Any shortcomings which in their opinion exist, must be correct^ regardless of what this may involve in extra staff or money. Judgement is Pais^f hastily and without any consideration of any difficulties with regard to either stan accommodation.. Q Secondly the doctors view the casualty department in a different light. There i? point in a doctor under present-day conditions of general practice, carrying out m1 surgery or treating extensive septic conditions which require incisions and dressing He is not repaid either by the State or the patient for his trouble, and he only a further anxiety and burdens to his already over-full day. The doctor too has to tend with long waiting lists for outpatient appointments. Every patient wants to a specialist. A case may not be acute but a second opinion may be of little value iflt ^ only be obtained in two months' time. The G.P. adopts the simple expedient of sen ^ such a patient to the casualty department. A second examination is made by a do .