It turns out that Britain’s National Health Service isn’t very healthy for babies or other living things. Reports the Guardian:
Scores of premature babies may be dying unnecessarily across England because the NHS mismanaged a reform of neonatal units in 2003, parliament’s spending watchdog reveals today.
Health ministers provided £73m over three years to link up hospital neonatal units in 23 regional networks that could provide specialist services to save premature and low birth weight babies.
But the National Audit Office finds that the Department of Health did not issue instructions for the units to be adequately staffed. As a result the service was overstretched. Its specialist nursing workforce was nearly 10% below strength. There were not enough cots to respond to every emergency and there was a lack of specialist 24-hour transport to move babies and mothers to other hospitals.
Jacqui Smith, when health minister in 2003, said she agreed with recommendations from the British Association for Perinatal Medicine for minimum staffing ratios. But the government did not order NHS trusts to implement them.
The NAO says there was “confusion” over whether staffing ratios were mandatory, making it difficult for unit managers to convince NHS trusts they needed more staff.
Half the 180 units providing neonatal services did not meet the approved ratio for high dependency care of one nurse to two babies. And only 24% met the intensive care ratio of one nurse to one baby.
The NAO acknowledges that the 2003 reform improved standards, leading to fewer babies travelling long distances for suitable treatment. But the improvement was not as great as ministers anticipated.
Every year about 60,000 newborn babies specialist care – about 10% of all births. In 1975 half the premature babies with a low birth weight died and many were stillborn. By 1995 the proportion had fallen to one sixth. In 2003 ministers said the reorganisation could save an extra 200-300 lives a year, but by 2005 the mortality rate had fallen by only about 120.
Units had to close to new admissions on average about once a week in 2006-07, mainly due to a lack of cots or staff shortages, the NAO says. A third of the units had a cot occupancy rate of more than 70% – the maximum recommended to avoid harming babies through increased risk of infection or inadequate levels of care.