Casualty at QEH

Perhaps 3.00am on a Saturday morning is not a particularly fair time to review an A&E department at a local hospital, but it's certainly going to mean you'll see it warts & all - and besides, you don't generally get to choose when you review Casualty as a client.

Don't even ask what I was doing there at that time of the day. Suffice to say I would hazard a guess that I was the only person there that wasn't either drunk, a drug addict or completely loony, and that that is not an atmosphere I would have chosen voluntarily. It was clearly not an atmosphere that the staff would have chosen either - and given the circumstances they handled it reasonably well - with the kind of stoicism normally reserved for saints and long-term soap characters.

Allow me to paint a picture for you (I am assuming you're all healthy sorts who have never crossed those less-than-hallowed portals.) You've parked the car (free, overnight - they graciously assume that at that time you're not a commuter who wants to park at the hospital and schlep the couple of miles to the local railway station every day) and you stagger through the doors clutching Little Johnny with a saucepan stuck on his head.

You'd normally have to take a numbered ticket but at night there are 'so few' people that you can just give your name to the receptionist. She's bored and cross at the same time - but you have to admit she's civil.

Your next challenge is to find somewhere to sit. There are plenty of seats, all joined together in rows, but it's still not easy to find somewhere that you'd actually want to sit. In one row there's a couple of hollow-eyed characters in knock-off designer sportswear that has never seen a gym. They glare at you, challenging you to come anywhere near, but the debris of - you're not quite sure what - has already made sure you're not going to disturb them.

Across the way, a bloke in his early twenties is wearing what, at 8.00 the previous evening, were probably his best clothes. His shirt still has the odd knife-edge crease and his gold jewellery still peeks out from under his collar. But his foot is smashed to pieces and covered in blood, as is his head. The whole of the front of his designer jeans and his special skinny-line shirt is caked in drying vomit. He's muttering to himself, and you're not sure it's all brought up yet...

You guide Little Johnny and his saucepan across the litter-strewn floor to try to sit next to an old woman who swears violently at you and starts screaming. You spot a place across the way, but a group of drunken teenagers carry one of their kind in between them, staggering and lurching, finally dumping her across the row and start waving and shouting at the receptionist that she needs to be seen immediately. You have already decided that the people who work here deserve some kind of medal. You've been here just a few minutes and they've been abused at least twice.

You finally settle down next to the payphone where someone decides to call Eastern Europe. It's obviously a bad line as they have to bellow, but they're clearly enjoying their chat.

You look around the place. There is an untidy display of leaflets about sexually transmitted diseases, which don't prove to be War & Peace. You attempt to decipher that the confusing chart which has various unexplained colours correlating to expected waiting times. You have not been given a colour, but you sincerely hope you are not Orange.

Your friend suggests a coffee, and you rediscover the concept of The Klix Machine - something you had previously thought had become extinct in the early 90s. A peer into the flimsy brown vessel currently warping under your fingers reveals a gooey glob of something that is very possibly but by no means certainly Non Dairy Creamer. You don't even want to go there.

About half an hour later, your wait is over. You are seen by a nurse who writes everything you told the receptionist half an hour earlier down, and tells you to go outside and wait.

A woman starts making a fuss to the receptionist that she isn't being taken seriously enough and she's having to wait. The receptionist is polite but firm and you are intrigued. What's going on here? Is this a regular, perhaps?

Your attention is drawn by another woman who was brought in in a wheelchair looking extremely pathetic. She had been coughing her guts up onto the floor until a cardboard dish was provided but had then slumped back into her chair. But she has suddenly noticed that everyone's busy, and she nips out of the wheelchair and into the loo, returning before she's seen.

An ambulance crew bring someone in and, by earwigging, you find out what's happened to the woman who's 'not being taken seriously.' The crew are furious. She called 999 with a headache, and when they suggested some Neurofen, made a huge fuss and insisted on being taken into hospital in the ambulance. In the meanwhile a man who had a heart attack had been forced to wait for 9 extra minutes.

Three and a half hours later you and Little Johnny are called in for tests. You apologise to the nurse that Johnny's clothes are still what he was wearing earlier that night; she's just grateful he's not covered in vomit. You get sent outside again to wait.

At 6.00am you go out to buy a parking ticket. It is officially morning.

An hour later, Little Johnny finally gets seen by a doctor. Clearly a junior doc, and clearly run off her feet, but politer and friendlier than you would have previously considered humanly possible under the circumstances.

You are finally out, five hours after you arrived. Equal amounts of WD40 and brute force have liberated Little Johnny from his saucepan, the sun is shining and a new staff has clocked on. The cleaners have arrived. You have never been so glad to get out of somewhere and find yourself humming "Oh, What a beautiful Mornin'..."

None of this is the fault of the hospital, as far as I can see. A & E seems to attract some real characters and it's up to these people to deal with them, day in, day out. The waiting room is covered in litter and all kinds of nasty stuff, but the cleaning staff can't be there all day. I don't know what you can do about the drunken chav element that make an experience like this as bad as it is. But those waiting times are scary. Short of extra funds I don't know what QEH could have done better under the circumstances.