DOCTORS staffing overstretched A&E departments have repeatedly pointed to their 'abuse' by patients who didn't need to be there.
Waiting lists for GP appointments and hospital assessments meant that some people were either inappropriately referred or turned up as a last resort out of fear that a delayed test may be impacting on a serious undetected illness.
Vulnerable people with addiction and mental health problems have also sought help at the doors of an A&E unit because the specialist services were simply not available in the community.
The result was 12 hour breaches - and even 24 hour breaches during winter pressures - of A&E waiting time targets became the norm, with the elderly and infirm particularly affected.
With the onset of the pandemic however, the situation changed almost overnight with some of the north's busiest A&E departments reduced to a trickle of attendances while waiting times virtually disappeared.
Fear of contracting coronavirus as well as not wanting to put further strain on a system preparing for a massive surge in cases led to many people staying away - a move that sparked an appeal from doctors to those sick patients staying at home to seek treatment.
As the north's embattled health system tries to navigate its way out of the Covid crisis and rebuild new services, a leaked document on a major overhaul of A&E has prompted some concerns.
The proposal to move to "ambulance only access" at the front doors of an A&E with other urgent cases triaged and seen in separate specialist facilities will no doubt create fear for those who had become dependent on emergency care.
Legitimate concerns have also been raised among healthcare professionals about their role, given the big focus on GPs and ambulance staff in triaging patients when they are already tackling severe frontline pressures with reduced resources.
What is certain though is that the north's A&E units cannot return to a situation where patients lie in hospital trolleys cheek by jowl while coronavirus remains at large and a vaccine is still some time away.
After almost two decades of reviews by experts who all came to the same conclusion and called for a systemic overhaul of the system, the need for our heath officials to act and engage with frontline staff on transforming emergency care has never been more pressing.
