Problems in staffing of emergency departments.

PREVIOUS speakers have recounted most of the difficulties at present being experienced in the staffing of casualty departments and these have been further amplified in discussion. It would seem more valuable, rather than re-iterating these, to put forward some possible solutions and criticize some of the solutions suggested by others. Before a clear decision can be reached it will be necessary to reconcile the often conflicting views of interested parties. The Department of Health, which has the job of developing solutions which may be applied nationally, relies for its advice on the profession. Sometimes, the previous speakers have put forward view points from positions of isolation and it is very necessary to attempt to reconcile these. At this stage it is necessary to state that the British Orthopaedic Association has failed to develop a trouble-free casualty service, and while this may not be entirely their fault, it is their responsibility because they accepted this burden. The Casualty Surgeons Association (of which I am a member) has to some extent exploited the situation in persuading the profession and the Department of Health to proceed with the creation of consultant casualty surgeon posts which in some instances might involve the appointment of existing medical assistants.