This paper describes two surveys carried out at the accident and emergency department of Queen Elizabeth Hospital, a specialist children's hospital situated in the east end of London. Both studies explored factors influencing attendance at the accident and emergency department. One was based on an analysis of recorded information (hospital notes) for a random sample of attenders, spread over a 12-month period. The second was based on personal interviews with a sample of children's parents. Both studies found problems with access to general practitioner care to be the main factors influencing attendance.