Anatomy of a crisis

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The winter of 1995/1996 produced an unexpected surge in the number of meningitis and suspected meningitis cases, leading to unprecedented pressure on paediatric and intensive care (PIC) beds throughout the country.

An early flu season and a high incidence of other respiratory illnesses added to the demand, and by early January, children's hospitals everywhere were turning patients away. A survey by the Independent at that time found that at least 300 seriously ill youngsters had been refused beds in the past year. The British Medical Association, the Royal College of Nursing, and the British Paediatric Association responded by demanding immediate government action.

There was a desperate familiarity to it all. In March 1988 a shortage of beds and nurses in PIC units in Birmingham was a factor in the Thatcher government review of the NHS, which led to the introduction of the internal market. Then in November 1993 the BPA launched a highly critical report, claiming that little had improved since 1988 and that children were dying or were left permanently damaged because of a national shortage of beds and staff.

The Government says it is a local matter for trusts and health authorities to sort out. But specialist doctors believe the solution is a national reorganisation of PIC, perhaps centrally funded, with a network of regional units and safe, swift ambulance transfer guaranteed between them. Children's lives, they argue, are too important to be left to the vagaries of the market. LIZ HUNT

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