EDITOR,—Richard Hobbs's editorial on the increase in emergency admissions—one of the most difficult and important problems facing doctors in district general hospitals—is disappointing in its bland analysis.1 The problem is certainly the rising tide of acute medical admissions, which reached a peak in 1993-4 but has been going on for a long time.2 A good deal is known about these admissions (Welsh Health Planning Forum expert workshop, 1994).

In my hospital, which serves a population of 140000 and has an integrated service …