I WRITE to beg you to stop referring to the time patients spend in the emergency department (ED) as a “waiting” time, or a time “to be seen” (“A & E targets record third worst week on record”, The Herald, July 28). These expressions are inaccurate and misleading. The patient’s initial point of contact on entering the emergency department is, or should be, with the triage nurse, and triage, or rapid assessment of a patient’s emergency status is, or should be, immediate. Most emergency departments then assign a time within which the patient must be seen by the emergency physician. This might only be a few seconds, but in any case, all true emergency patients will be assessed within “the golden hour”.
The medical consultation comprises history, examination, investigation, diagnosis, treatment, and disposition. To describe this as a “waiting” process is quite wrong. Of course there can be delays to disposition, notably through access block to the ward, but this is beyond the control of the ED.
A patient on the waiting list for a hip replacement might wait, truly wait, for years. This rather puts the ED “time to disposition” (my preferred terminology) in perspective, and shows up the absurdity of turning ED “performance” into a political football. It suits opposition politicians to talk about “waiting times” and “time to be seen”. Annie Wells for the Scottish Conservatives said: “Over a fifth of patients are not seen within the SNP’s target time of four hours”, and Jackie Baillie for Scottish Labour said: “A&E waiting times are spiralling further and further out of control.” Either they are ill-informed, or sleekit.
Emergency physicians are not interested in the four-hour rule. Instead, they try to ensure the patients in the department are in a safe environment, and they do their best for the patient in front of them, however long it takes. Politicians should stop trying to micromanage an environment they don’t necessarily understand. They would be better to visit the ED staff, not to tell them what to do, but to ask them, “What do you need?”
Dr Hamish Maclaren, Stirling.
NHS PROBLEMS LIE IN MANAGEMENT
GAVIN Tait (Letters, July 28) says that he cannot fathom how the public have accepted the present circumstances in the NHS.
He makes regular contributions and it is good to see his take on what he says has existed for the last 15 years, a point I would dispute, since I have been retired for nearly 30 years and worked in it for 28 years before that and all that has happened is that it has become steadily worse.
I have absolutely no complaint about the skills, expertise and dedication of the staff. My own life was saved and that of my wife by people whom I cannot thank enough. The problem lies in its management quality and construction and the fact that there is no real accountability in the upper echelons (a bit like our political classes).
Lip service is paid and statistics bandied about, but the public have little effectual leverage.
I foolishly belonged to a forum interface and after a brief off-the-record discussion with an ex-management colleague who recognised me from the past, I realised that the public's priorities were not even on the agenda.
Tom Law, Sandbank, Argyll and Bute.
SCOTLAND'S TWIN ENERGY BOOST
TWO items in today's media brightened up my day. The first was your article about the experimental work being carried out at old mine workings at Cuningar Loop in Rutherglen with scientists hopeful that untapped mine water could generate enough geothermal energy to heat more than 180 million homes ("Scientists in bid to transform disused mines into renewable energy sources", The Herald, July 28). Even a fraction of that would be a marvellous addition to Scotland's energy needs.
The second item was heard on BBC TV news at midday and concerned the connection to the National Grid of electricity generated by the world's largest wave power turbine anchored in the Pentland Firth. Although the amount generated is only enough to power 2,000 homes, the prospect of many more such turbines is being situated in suitable sites around our coast is exciting indeed.
Two examples of poor wee Scotland punching above its weight in the world of green energy production?
Ken MacIver, Milngavie.
WE NOW HAVE EXPERTS EVERYWHERE
CLIMATE change, Brexit, and the Covid pandemic have created many new jobs. Obscure university professors and previously unheard of quango pontificators are now public figures, with a grateful nation hanging on to their every word. Experts are at last freely available.
Surely we are now totally equipped to deal with anything the future may hold?
Malcolm Parkin, Kinross.
CHECKING UP ON HEADGEAR
REGARDING Jim Butler's letter (July 26) regarding the chequered bands on certain uniform hats, the official history of the Incorporation of Bonnetmakers & Dyers of Glasgow (one of the 14 ancient crafts of Glasgow) provides an interesting commentary on what it refers to as "dicing" on headgear:
"The legend regarding the dicing on the bonnets of Scottish Regiments is that it perpetuates the ‘fesse-checky’ on the arms of the Stewarts but reproduced in military colours instead of the original azure and argent. Dicing is now used in a variety of colours for bonnets worn with the kilt."
Robert Linton, Deacon, the Incorporation of Bonnetmakers & Dyers of Glasgow.
ALBERT HAUL
LOOKING at the photo of the Albert ballroom ("Glaswegians danced the night away at the Albert, 1957", The Herald, July 28) reminded me of my own long-gone dancing days in Glasgow – the Majestic and the Flamingo were my preferences. Not the Albert, which was known as “Grab a Granny”.
Eric Macdonald, Paisley.
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