Surgeons criticise neonatal provision

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The Independent Online
ONLY ONE region in the country has an adequate service for new- born babies needing operations, surgeons' leaders said yesterday.

A report from the Royal College of Surgeons says that improved chances of survival in premature babies and antenatal scanning which alerts doctors to abnormalities means that more can be done for the new-born, perhaps avoiding permanent handicap.

No general surgeon should be asked to perform surgery on the new-born, who should always be treated by specialists, they say.

About 1,500 babies a year are born in Britain needing surgery for a variety of problems including some rare cancers, malformations, and blocked or twisted ducts and organs.

The report from a royal college working party and the British Association of Paediatric Surgeons calls for all neonatal surgery to take place in specialist centres which include full facilities for mothers; for neonatal surgeons to have a full range of support services available, and for all centres to have three or four specialists appointed.

This will not always mean employing extra staff. In East Anglia, for example, where specialists are based in Norwich and Cambridge, the surgeons could form a single unit to provide the service.

In a region by region analysis, the report says the West Midlands has less than half the number of paediatric surgeons it needs. Only Mersey, with a complement of four paediatric surgeons and one paediatric urologist, is adequately covered.

The report was in response to the 1987 and 1990 confidential inquiries into deaths during or after surgery which found that surgeons operated on patients for conditions for which they were not trained or did operations outside their main field of expertise.

Mr David Thomas, consultant paediatric surgeon at St James's University Hospital, Leeds, a member of the working party, said that neonatal surgery was cost effective.

'The overwhelming number of babies we treat go on to lead lives of normal quality and as far as we can tell of normal duration,' he said.

Commission on the Provision of Surgical Services, Report of the Working Party on Surgical Services for the Newborn; Royal College Surgeons and the British Association of Paediatric Surgeons; 35-43 Lincoln's Inn Fields, London, WC2 3PN.

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