Professionals' and Parents' Perceptions of A&E Use in a Children's Hospital

Helpful keywords in accessing literature on the use made of hospital accident and emergency (A&E) departments are ‘misuse’ ‘abuse’ and ‘inappropriate’. While the medical literature is inclined to present patients (and, in the case of children, their parents) as irresponsible, or misguided, social scientists looking at similar data have tended to act as apologists for patients, explaining A&E attendance in terms of poor access to GPs, mistaken beliefs about the relative skills of hospital-based doctors and GPs and ‘lay’ health beliefs. Both of these approaches see the patient (or parent) as passive recipients of health care, rather than active caretakers of their own or their children's health. On the basis of a study of minor ailments presenting at a children's A&E department, this paper explores the differing views of health workers and parents. It suggests that a view of patients (parents) as largely passive custodians of their own or their children's health is inadequate. Patients (parents) can and do play an active part as providers of primary health care and their decisions to use A&E are not as irrational as health providers sometimes suppose. In this light, attempts to ‘re-educate’ parents to use A&E in a way which would be more acceptable to health providers is unlikely to succeed.