Readers may be interested in the following abstract from the Lancet of October 1869, “The Lancet investigation into the administration of the out-patient department of the London hospitals”.

On the morning in question, 120 patients were seen and dismissed in an hour and ten minutes, or at the rate of 35 seconds each. Who shall say what mistakes were made? None can tell...they are dismissed with a doubtful dose of physic, ordered almost at random, and poured out of a huge brown jug, as if the main object were to get rid of a set of troublesome customers, rather than to cure their ailments. A physician and surgeon have been appointed to stand inside the doors of the waiting room. They are to receive and examine the patients as they enter and distribute them amongst the various departments, according to their judgement. They are also authorised “to refuse treatment to any person who appears not to be a fit object of charity.”Naturally desirous of gaining all the experience possible, the house-surgeons have been in the habit of keeping all the interesting cases under their own care, and of sending the chronic and incurable to the out-patient room...

There are three articles in all,^1–3 which make for a fascinating read. If the language used were updated slightly, they could easily have been written 150 years later.