More attention should be given to the development of child and adolescent services, an area in which we are very badly served. There is no mention of this matter in the report, but every large accident and emergency department should have psychiatric services and backup. There are several reasons for this. Many of those who present at accident and emergency departments at all hours of the night are more in need of psychiatric care than surgical or other interventions. They can be very difficult for staff to deal with. It should be almost a sine qua non for accident and emergency departments to have full psychiatric backup.