Hospital records show true scale of violence

Madam, - Our neighbours in Britain have recently made a dramatic "discovery" regarding violent crime, prompted by national anguish over a wave of fatal teenage stabbings.

The revelation that seemed to surprise so many is that statistics for violence may be higher - and more accurate - when extracted from hospital emergency departments, rather than from police records.

For years, many of us working at the healthcare front line have exhorted the powers that be to recognise the value of the "real-time" demographic data that can be mined from our patient figures.

They are not just more telling, but are available far sooner than those in official reports and underpin the immense potential of the emergency department as a "public health observatory".

Given that over a quarter of the population attend a hospital emergency department each year, it really is time that these attendances were scrutinised for what they tell us is actually happening in our society, as opposed to the tardy retrospectives often found in dusty academic tomes.

The rising tide of aggression and violence in these islands, fuelled by alcohol, cannabis and cocaine, has been observed for years in our hospitals, but has been officially underplayed (for much the same reasons as we have turned a blind or impaired eye to congestion in our emergency departments).

Sadly, due to the same under-resourcing, we are as powerless to harvest the fearsome but fascinating facts of our society's (ill) health as we are to admit patients promptly to beds. And "proving" (or not) that a great number of teenage impulses are not hormonal, but toxicological, is clearly too costly for society yet to bear.

Knowledge could be powerful but determined ignorance (what we don't study, we can endlessly dispute) means that the drug- and drink-fuelled violence that will plague our society for the foreseeable future will continue to be described as "baffling". It is nothing of the sort, sadly, although the failure of governments to study so many pressing public health issues as they queue up at the doors of our emergency departments (and police stations) remains a kind of mystery. - Yours, etc,

Dr CHRIS LUKE, Consultant in Emergency Medicine, Mercy University Hospital, Cork.

© 2008 The Irish Times

This article appears in the print edition of the Irish Times