ELDERLY or disabled out-patients at West Middlesex Hospital may be having difficulty getting to, and accessing, the different departments, according to one visitor at the Times' Chiswick surgery.

Pat Fisher regularly visits the chiropody and physiotherapy department, which is a detached building at the rear of the hospital. She claims the long walk is almost impossible for people in need of such treatment, especially in the cold winter weather.

Miss Fisher said: "It's amazing, these modern offices and hospitals, they always have long frontages to walk up. The people going to these hospitals are unwell. These designers don't think of the people who actually use the hospital. Planners never talk to the patients."

Fortunately, Miss Fisher has found a form of transport that can take her almost directly to the door. She has a taxi card from Hounslow Council which allows her to travel around at a discounted price. But the 54-year-old pointed out that few people know about these cards.

She said: "No one informed me of it, social services, no one, yet all the London boroughs have this taxi card system."

The scheme allows a person to take up to 104 taxi trips a year, with extra trips added on at the council's discretion. To qualify for the card a person must be registered as blind, severely disabled or be able to provide medical evidence of immobility. A registration form can be obtained by calling 020 7484 2929.

West Middlesex Hospital itself is currently going through a phase of redevelopment to change its collection of separate Victorian buildings into a more accessible, unitary hospital.

A spokeswoman for the hospital said: "The focal point has been access for all, not just able bodied people. We are creating a clear route to the main door of the building, which the 117 bus will be able to drive along."

A flat entrance had replaced the ramp allowing easy access for people with wheelchairs or prams. Patients entering the hospital can also ask the reception staff, porters or a hospital volunteer to assist them to their chosen department.

The volunteers are a particularly valued commodity. Anyone who has a few hours a week to spare can become a volunteer, and they are always in demand. To find out about volunteering call 020 8321 5413.