Boy's death hignlights NHS blunders

LIZ HUNT

Health Editor

A damning report on the death of a ten-year-old boy who was ferried between four hospitals in search of treatment, has revealed a shortage of specialist beds and organisational blunders which are threatening the care of very sick children.

The official report was published on the same day as it emerged that the liver of ecstasy victim Leah Betts had to be given to a patient in Spain because no British hospital could accept it; two transplant centres said this was because they had no intensive care (IC) beds.

The incidents have fuelled fears of a mounting crisis in emergency care in the NHS which peaked this winter, when scores of adults and children had to be refused admission to IC units.

The Government, under intense pressure, has been forced to act and today Stephen Dorrell, the Secretary of State for Health, will unveil a wide- ranging package of proposals to offset a crisis.

The case of Nicholas Geldard, 10, came to national attention after he collapsed at home in Stockport on the afternoon of 7 December. A report of the independent inquiry team, chaired by Judge Bill Ashworth, found that four children's hospitals with IC beds in Liverpool, Manchester, and Sheffield, had to refuse to take the boy. Their report calls for the urgent re-organisation of intensive care for children in the North West with brain damage or neurological problems. In a strongly-worded conclusion it says: "The time for talk and discussion ... is over. The need now is for the proposals in our recommendations to be put into effect as rapidly as possible. This needs firm and resolute leadership. We must put the children first."

According to the report, the case of Nicholas Geldard reveals "a curious mix of praiseworthy staff commitment; idiosyncratic call-out arrangements, ghastly misjudgement and insensitivity in sending Nicholas to Leeds General Infirmary ..." after he was brain dead, and, "a ponderous bureaucracy that bedevils clinicians seeking paediatric neurological and neurosurgical advice and treatment."

Nicholas was first admitted to Stockport Infirmary's casualty department and was referred to nearby Stepping Hill Hospital for further investigation. However, the brain scanner which would have diagnosed his condition was not available out-of-hours. The on-call consultant radiologist at the hospital was not contacted. The "make-shift" on-call system at Stepping Hill was criticised in the report as being "bound to fail. The only surprise is that it took nearly two years to do so".

It wasn't until eight hours after Nicholas collapsed that a doctor found an IC bed at Leeds General Infirmary, about 60 miles away, by which time the boy was probably brain dead, according to the report. In the meantime he had been taken to Hope Hospital in Manchester for a brain scan.

The inquiry team said that it was "only chance" that Nicholas's death was not directly the result of the blunders. He suffered bleeding into the brain which is extremely rare in children under 15.