ABSTRACT
Emergency care in the UK has its roots in historical differences between treatment for the wealthy and for the poor. Links between co-operatives and ambulance services are strong in some areas, where ambulance service communication networks, vehicles and drivers are supplied, under contract, to local co-operatives. A large part of the problem lies in deeprooted prejudices within different professional groupings. Individual services have developed in isolation, each with their own history and value systems. In the hospital system, prestige and rewards accrued to those doctors who were best insulated from the undifferentiated mass of patients. The increasing use of triage nurses in accident and emergency (A&E) departments, designed to ensure that high-priority patients with serious conditions receive rapid treatment, ensures that patients with minor problems can face lengthy delays in crowded waiting rooms. Secondary care services and community nursing services are hierarchical and the staff within them are employed by their respective trusts.
