NHS MATERNITY DISGRACE

A couple who lost their baby after they were turned away from the nearest maternity unit have exposed a crisis of overcrowded hospitals shutting their doors to women in labour. Andrew and Rachel Canter have launched a campaign to prevent other mothers and babies being put at risk by maternity hospitals closing to new admissions for up to 30 hours at a time. The couple's son, Jake, was born dead after they were forced to drive past the maternity hospital where they had planned to be admitted and take a 20-minute detour to another unit. Rachel was in the late stages of labour and needed urgent attention.

Their case reflects a national trend for busy maternity hospitals frequently to close their doors to new admissions, even turning away women who have booked places on their wards. Evidence compiled by The Sunday Times shows:

* In one year, maternity hospitals in Greater Manchester had to close on 90 occasions, some for up to a day. One had to close 29 times. A shortage of staff has forced Greater Manchester and East Cheshire hospitals to plan cuts in the number of maternity units from 13 to 8.

* Women are frequently turned away from London's major hospitals. St Thomas's hospital is understood to have closed to new admissions three times in a fortnight but has refused to disclose details. Chelsea and Westminster hospital has closed its maternity unit four times in the past year for up to 11 hours.

* Last month a woman in labour was turned away from maternity hospitals in Hastings and Eastbourne before setting off on a 30-mile journey to Pembury, Kent.

* The Barratt maternity unit at Northampton general hospital had to close during two weekends in March, once for up to 30 hours, forcing 10 women to be redirected.

The problems have emerged as the NHS is bracing itself for the permanent closure of maternity units across the country. David Nicholson, its chief executive, recently warned that the number of maternity hospitals would need to be cut. Managers say there are not enough doctors.

Andrew Canter, who runs an advertising agency and lives in Welwyn, Hertfordshire, believes his son could have lived had Barnet maternity unit not closed to new admissions on the day his wife gave birth. He said: "This baby could have been born alive. It was an absolute disgrace that we were treated in this way. This was a classic case of underfunding and understaffing. We now want changes so that Jake didn't die in vain."

The Royal College of Midwives says a lack of doctors and midwives is responsible for the closures. Barnet and Chase Farm Hospitals NHS Trust said the maternity unit had to close on the weekend that Jake Canter was stillborn last October because it was too busy. The hospital had not been designed for the number of women who gave birth there

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Long delays for cancer diagnosis in Australia

Women suspected of having breast cancer are waiting longer than seven days to be diagnosed because of a national shortage of pathologists. Instead of the recommended 24-hour diagnosis, the Royal College of Pathologists of Australasia (RCPA) reports that some women are waiting more than a week to be diagnosed. The lack of pathologists also means some women wait as long as four months for autopsy results after a miscarriage.

The Sunday Telegraph revealed earlier this month that some families had been forced to wait a year to learn their loved ones' cause of death because the Westmead morgue had been unable to fill vacancies for forensic pathologists. The college has blamed the Commonwealth and state governments for failing to honour commitments to fund additional training positions to address the problem.

RCPA chief executive officer Debra Graves said the situation had reached crisis point, with patient health potentially put at risk. She said some women with breast lumps had to repeat diagnostic procedures because of the pathologists shortage. Dr Graves said it was advisable that a pathologist perform or supervise diagnostic procedures to ensure the correct cells were taken, but the unavailability of pathologists had resulted in cases where incorrect cells had been taken, forcing patients to repeat procedures. "It is best practice to have a woman with a lump diagnosed within 24 hours, but what we are seeing at the moment is women having to wait for anything up to a week because they've had to come back," she said. "That is a terribly stressful time for a woman, but it's happening everywhere and it's getting worse."

According to the RCPA, there are 70 pathologist vacancies nationally, with the shortage affecting hospitals across Australia. Figures from the college show there are 1290 practising pathologists in Australia, 20 per cent of them aged over 60. In 2003, the Australian Medical Workforce Advisory Committee recommended that an extra 100 training positions be created over the next five years. But since that meeting, only 39 new positions have been funded instead of the recommended 300. The college put forward a budget submission to the Commonwealth for an additional $13.75 million to fund an extra 40 positions. The Commonwealth agreed to fund 10. The NSW Government has provided funding for four pathologist positions.

In the most recent RCPA Path Way journal, the college cites a cancer being undiagnosed by an overworked pathologist as a worst-case scenario if the shortage is not immediately addressed. A spokeswoman for Health Minister Tony Abbott said the training of pathologists was the responsibility of state and territory governments, but added the Commonwealth had a program to train pathologists in the private sector. "In 2004-06, $3.7 million in funding was allocated," she said.

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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