Primary care emergency centres Will result in chaos

EDITOR, - Before general practitioners proceed in their experimentation with out of hours services, I wish to plead for less muddled nomenclature. Tom O'Dowd and Hamish Sinclair report the collapse of general practitioners' enthusiasm for 24 hour availability under a tidal wave of patient “consumerism” and the plans for primary care emergency centres, to which existing accident and emergency departments could reroute some of their patients who attend inappropriately.1

But do the authors really believe that fewer patients will attend inappropriately or, more importantly, that the public (or even paramedical staff) will be able to distinguish between a “primary care emergency” and an “accident and emergency department emergency”? Plainly they are unaware that accident and emergency medicine (the fastest growing discipline in Britain2) originated in the chaotic conditions of the 800 casualty …