Children 'are being let down badly by many NHS hospitals'

Children are being let down by the care they receive in hospitals across England, a critical report by the health watchdog says today. Nearly one in five hospitals is failing to provide sufficient emergency life-support care for children at night, while in many others child protection and training staff to treat children are still largely overlooked. In the review, carried out by the Healthcare Commission, three quarters of the hospitals examined scored only "fair" or "weak" for the overall service provided for children.

Surgeons in 8 per cent of hospital trusts did not operate on enough children to keep their skill levels up, while 16 per cent of paediatric inpatient units did not carry out enough work to reach the minimum recommended professional level.

The findings, described by child health experts as horrifying, suggest that many hospitals have failed to comply with national guidelines published by the Government four years ago. The commission said its report showed cause for serious concern and constituted a "wake-up call" for those hospital trusts that did not put the health of children first. It pledged to put pressure on the worst hospitals to improve. The report found that 1.8 million children attended mixed adult-child A&E departments last year and that 2.5 million children went to mixed adult-child out-patients, while 62,000 children were classed as day cases.

The commission praised the work of the majority of dedicated paediatric inpatient departments, with 70 per cent ranked either good or excellent, but it said that the overall service was less impressive. It also looked at out-patient wards, accident and emergency departments and day-surgery cases in 157 hospital trusts.

Among the best hospitals included Great Ormond Street Hospital for Children NHS Trust, the Royal Liverpool Children's NHS Trust and Sheffield Children's NHS Trust. The list of the weakest included hospitals in Brighton, Co Durham and Scarborough. Of those found to have insufficient life-support care last year, eight had failed to assure the commission that the situation had since been remedied.

Anna Walker, chief executive of the Healthcare Commission, said that the review had been carried out after recommendations from reports such as the Victoria Climbie inquiry, which listed a catalogue of failures in care. The eight-year-old died from abuse and neglect seven years ago, despite having been seen by dozens of healthcare and social workers who could have raised the alarm. As part of its response to the case the Government set up the National Service Framework for Children and Young People in 2003, but Ms Walker said that some hospitals were still neglecting the guidelines. "This is a wake-up call to the trust's boards," she said. "Do not let another Victoria Climbie take place.

"We have found areas that are positive - the results from the paediatric inpatient wards are good. But we are very concerned about the overall results - the 75 per cent fair and weak results. Children's healthcare is not one of the main services like cancer, hips, stroke or heart disease. It is a specialist area and can tend to get overlooked."

Maggie Kemmner, the report's author, suggested that rota problems and a lack of suitable trained staff had caused 12 per cent of hospitals to report a lack of life support for children during the day, a figure that rose to 18 per cent at night Patricia Hamilton, president of the Royal College of Paediatrics and Child Health, said that she was horrified and dismayed by the report. "Seventy-five per cent of hospitals were rated as fair or weak. This is unacceptable, but not surprising, as children's services have long been underresourced and have not been given the priority they deserve," she said. It confirmed the view of the royal college that the current level of paediatric units could not be sustained. Ivan Lewis, Minister for Care Services, said last night that he would consider any action to make a positive difference.

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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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