http://news.bbc.co.uk/1/hi/uk/8591395.stm

Maybe those who cause trouble in the hospital should be fined as well? With the cost award to the hospital to cover such policing costs.

Part of the problem is that many of the people who are under police custody or have police cover also require medical attention. Drunk people can fall over and injure parts of their faces, requiring stitches. Or they can have a head injury and require examination and observation to determine whether they need a CT scan of their head to exclude a potentially fatal bleed.

Then you have mentally-unwell people who are aggressive or at risk of harm to themselves (and/or others) and therefore need a medical and psychiatric review. Many of them need urgent admission under the care of psychiatrists.

Fining them doesn't mean much since many of them don't have money. Making them do community service or similar would perhaps be more beneficial and more effective?

I do not think that those in custody already count. Their cost would be covered by the police. They can be charged with additional charges if they kick off whilst in custody.

I think the differentiation is between those in custody already and those who make their way to the hospital in other ways who then cause problems once they are in the hospital is important. For example a drunk who is found unconscious in the street is brought into hospital by ambulance, and then regains consciousness to then cause trouble is a case in point. The hospital would either pay police to operate in hospital grounds on the same basis as football grounds do. Or call them in when needed.

The mentally ill will present themselves at all hours not just Friday and Saturday nights. Also they will be better provided for in a cell, where they cannot harm others. The psychiatry staff work 9 to 5 so holding them till they can be seen is better. The police already have powers to do that.

Fining really only hits those that work, as you say community service might be a better option, plus alcohol treatment.

Maybe if the waiting times weren't ridiculously long patients wouldn't need to get violent.

Yes but that is what triage is for. They can process more important cases through quickly. To be honest if you are in hospital because of a minor incident then you should expect to wait. It is the downside of a free universal healthcare system. I accept that as a reality, no point getting worked up about it.

I'm sorry, but 2+ hours just to be assessed and then 6+ hours to see a doctor is ridiculous (and that's on a quiet evening).

I would agree, but triage really should be assessed very quickly so that if someone had something communicable they can be isolated. Otherwise someone with swine flu or plague or whatever does not infect the entire waiting room. It does depend on what you went in there for.

And if people attended appropriately and were more responsible, we wouldn't have problems with waiting times.

People who get seen straight away are those in distress or whose condition is life-threatening. If you have a knife sticking out of you and blood pouring everywhere, I'm sure you would be grateful to be attended to straight away rather than see some silly git who complains about waiting times!

The crap thing about waiting times is that the more urgent cases sometimes wait. I've said this before: I've had to deal with someone who had a cold (wanted to see if there was anything that could make it all better; as of yet, there's no cure for the common cold), before I could see someone who had chest pains and essentially had had a heart attack.

There are times when it's quiet and I'm sitting around waiting for the next patient. These occur very rarely but do happen. Christmas Day was a typical example. Then there are times when it's so busy that we're seeing patients after the four hour target. The only way to speed up would be to make serious shortcuts that are potentially fatal.

I'm truly astounded at the number of people who have had something going on for a week or a month, and suddenly decide to attend A&E. If you've had a headache for the last three months, there's nothing I'm going to do to improve it straight away. Similarly, some patients turn up because they can't get their medication. They think A&E is their OOH service.

Some people are simply morons.