I AM sure I am not alone in saying I do not quite understand what Professor David Kerr is trying to say or achieve (Letters, March 23). Instead of thinking how to improve the accident and emergency departments to meet the needs of the people, he has in mind to reduce the number of patients attending by up to 70% to increase the efficiency of the service. A truly Gilbertian solution.

To use the term "unscheduled" for urgent care is truly managementspeak. No matter how apparently trivial an injury, pain or bodily upset is to an expert, it is something very real to the victim who often wishes help.

To recommend a form of triage "close to home" at all hours by a GP, an experienced nurse, or (believe it or not) NHS 24 strikes me as wishful thinking. Why not include a neighbour with a first-aid certificate?

The A&E service in Scotland is certainly not perfect but it really does do a worthwhile day-to-day job. Yes, improvements are to be hoped for, but I'm not sure the recommendations of a professor of clinical pharmacology from Oxford are the best way forward.

Dr William O Thomson, 7 Silverwells Court, Bothwell.