A government plan to cut senior staff in paediatric wards and neonatal units and replace them with trainee doctors will put infants at risk, doctors and patient groups have warned.
Under the Government's controversial Modernising Medical Careers (MMC) programme, senior staff on some paediatric wards will be replaced by trainee doctors from August.
The move is part of a government plan to reform training for NHS doctors. Patricia Hewitt, the Secretary of State for Health, said recently that this was needed "not just for junior doctors themselves, the workhorses of the NHS working quite outrageously long hours, but also for the sake of patients".
Busy paediatric wards have up to seven specialist paediatric senior house officers (SHOs) - doctors with up to four years' experience. Most could be replaced under MMC.
In future, trainee doctors with one or two years' experience will spend four months in paediatrics before moving on to another specialism, and would not necessarily have any interest in that area of medicine.
The move has alarming implications for the 45,000 babies born prematurely each year. Babies born at 23 weeks have a 17 per cent chance of survival and require expert medical support, while half of all babies born before 30 weeks suffer from apnea, which causes them to stop breathing.
Childbirth experts said last night that patients should be able to expect to be looked after by fully trained staff. "We do not want a situation to develop where mothers and babies are put at any risk because of a lack of senior support," said Sonya Murray, of the Baby Gurus, which advises pregnant women.
Senior medical staff warned yesterday that inexperienced trainees are unsuited to difficult procedures such as putting an intravenous drip line into a baby's arm or treating vulnerable premature babies.
A senior London doctor, who asked not to be named, said the impact on the care of vulnerable young children and premature babies could be disastrous. "Paediatrics is a specialism and, to be safe, people must be trained," the doctor said. "If things go wrong during pregnancy, you would call to the delivery an SHO who would deal with any complications. There is a big difference in a critical situation between an SHO and a trainee. These changes could result in the death of a baby or brain damage. MMC is a bad idea and against the principles of good patient care."
The charity Action Against Medical Accidents said the new regime had "worrying implications" for the safety of patients in all areas of medicine, in particular for children.
Remedy UK, a 13,000-strong doctors' campaign group, said it was worried about patients under the new system. "If the overall skill mix in your department does not include the capability to carry out basic procedures, it will put more pressure on seniors to perform them instead," said a spokesman. "They will have to shoulder much more responsibility to run the wards.
Remedy UK accused the Department of Health of "dumbing down" doctors with MMC. "It used to take 21,000 hours of training to become a consultant but this has been reduced to 6,000. There is a move towards dumbing down the system rather than aiming for excellence," said a spokesman.
The Healthcare Commission, the medical watch-dog, said it would monitor MMC in children's wards.
The Department of Health denied it was planning to replace specialist paediatric staff with inexperienced doctors and said trainees must have some specialist experience before taking up posts.
"Rotations of doctors in training has always taken place every six or four months, and NHS trusts have always handled this with a robust induction for trainees," a spokesman said.
The baby midwife
The baby midwife is scrubbed and gowned ready to receive the baby from the obstetric registrar and hand it on to a paediatrician.
The obstetric registrar
Performs the operation to remove the baby surgically from the mother's uterus. Typically, he or she would have a minimum of four years' experience.
The scrub midwife
An experienced midwife who assists with the operation, mainly by handing instruments to the obstetric registrar from a sterilised tray during the operation.
A registrar with a minimum four years' experience who administers powerful epidural anaesthetics, allowing the patient to be conscious but feel no pain.
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