We were very grateful to Leaman for his contribution that forms the first part of this debate. He is voicing concerns of many on the front line of A&E feel and we acknowledge his forthright and courageous approach. Equally it can be easy to criticise but difficult to be constructive, especially in such an arduous task as improving the UK emergency care system. We therefore have invited responses to the issues raised in the hope of stimulating debate on these critical issues for emergency care in the UK. We thank all the authors in this section for their hard work and well argued contributions to this debate.

JW/PD