The last time I used NHS Direct call centre I was referred to the out of hours clinic, which was very good. Saved me sitting in a crowded late Saturday night (after 11:30pm) A&E packed with drunken yobs and yobettes.

Turned out I had blood pressure something like 240 over 112 - stupidly high. (The doctor broke out into a sweat while he took my BP the second time and immediately referred me to Observation ward in A&E) I don't think waiting in A&E forever until the triage nurse could see me would have helped my condition much.

The 2 other times I have called NHS Direct (when I found out my daughter passed away and very bad case of food poisoning) I was referred to the out of hours clinic where I was seen quickly by the doctor (usually from a rota of GPs) who was not rushed in every direction by the demands of a busy A&E.

Other events where I was in near screaming pain (menorrhagia) I went directly to A&E on the advice of GP who could not see me, I sat 3 to 5 hours, shaking, moaning and weeping before I was seen by a doctor.

NHS Direct call centre nurses are not there to diagnose. They are there to advise and direct callers based upon the symptoms described and that they do. They have the clout to refer you to out of hours clinic (you cannot just show up).   

When you are sick or injured out of hours, would you rather talk to a qualified nurse or a someone with medical training "comparable" to emergency 999 dispatcher? What if it isn't even as much training as 999 dispatchers receive?

It is all very well to say shut the call centre down and give the GP surgeries the resources to take up the slack. But the NHS and the current government is not likely to do this.

I do agree that misuse of medical resources by the Friday and Saturday nights all right for fighting crew, should be repaid by them that abuse it. However that is another strand of administration that the NHS and the government do not want to pay for. It would probably turn out to be more expensive to run than it's worth.