SOME patients have to wait as long as four hours to be treated in Bolton's new accident and emergency unit.

And the demand on services is bound to get worse when the casualty department at Royal Bolton Hospital has to cope with an influx of 2,800 out-of-town ambulances. There will also be an unestimated number of "walk-in" and GP-referred cases from patients to the south and west of Bolton.

Hospital chiefs are planning to increase the number of specially trained nurses in the unit from three to nine and are considering basing a GP in the unit for non-urgent cases. It is to be hoped that this will be enough to cope with the numbers.

At Bolton Council's health service liaison committee Mr Mike Ruane, chief executive of Wigan and Bolton health authority, said a lot more information was needed before blank cheques for more resources were issued.

But there seems to be ample information already to indicate that there are going to be problems. Health experts expect the full impact of the outside patients to be felt in about six months time.

John Hartshorne, of the Bolton Community Health Council has made the point that everyone who goes to a casualty department believes their case is serious, although the experience of the staff suggests that some patients use casualty when they should be going to see their GPs.

But the time to tackle the difficulties is now. Nobody should not have to wait for hours before they are dealt with. The warning signs are there and they must be heeded.

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