I WELCOME Mr McLeay's comments about the quality of care provided by the Accident and Emergency staff at York District Hospital (March 20).

I would like to respond to his other comments regarding expenditure and staffing.

Funds for rebuilding the new Accident and Emergency department came from a Government initiative to improve the structure of A&E units.

The one-off grant was only available to be spent on the fabric of the building and on equipment, and could not fund medical or nurse staffing.

I believe the new department offers an excellent environment for patients and staff, although there are a few issues which still need addressing such as a patient information system (and TV) in the waiting area. This is due to be installed in the next few weeks.

Although we try to keep people informed about the waiting times this is sometimes difficult when the department is very busy and when staff are actually engaged in treating other patients.

Mr McLeay's comments on the waiting times and lack of staff are valid.

The main issue influencing the recruitment of more medical staff at the weekends is finance - the trust is now proposing to withdraw some of the existing weekend medical cover, which can only make the present situation worse.

We should like to enable our nursing staff to independently practice their skills and treat patients with a range of conditions who do not necessarily need to be seen by a doctor. We already have a number of nurses that have undertaken an intensive nurse practitioner training programme to do this work.

Unfortunately, there are insufficient resources to employ them alongside the general number of nurses required to run the department.

Michael J Williams,

Clinical Director Accident & Emergency Services,

York District Hospital.

Updated: 10:42 Wednesday, April 04, 2001