Trusts need to work together to avoid delays in paediatric surgeryBMJ 2010; 341 doi: https://doi.org/10.1136/bmj.c3711 (Published 14 July 2010) Cite this as: BMJ 2010;341:c3711
All rapid responses
Perhaps its significant that a week after publication, there has not
been a single response to this news item. But what could be more
important, or scandalous, than the news that "the number of surgeons in
England who can perform routine operations on children has dwindled"?
As a general surgical trainee in the early 1980's, I carried out almost
the whole diet of children's emergency abdominal surgery under the
supervision of excellent consultant trainers. Working in a general
hospital, we were proud of our care and had excellent results, rarely
having to request transfer to dedicated childrens' centres.
But does the article illuminate the real reasons for the shocking
decline in the availability of childrens' surgery in district hospitals?
True, there is a a shocking bureaucracy and almost a culture of fear,
unique to Britain, which has multiplied around the care of children and
for which society as a whole is responsible. But why did the Royal College
of Surgeons keep silent in the past few years when its paediatric surgical
committee made ever louder noises to the effect that childrens' surgery
should be done by dedicated childrens' surgeons? This undisguised bid to
strengthen one sub-speciality sent the strongest of messages to those
remaining general surgeons who had provided perfectly good childrens' care
during their careers that their services were somehow deficient.
Its not good enough now for the Chairwoman of the Childrens' Surgical
Forum simply to complain that young patients "should not have to face long
journeys or delays for relatively straightforward operations which until
recently would have been available at their local hospital". Why doesn't
she identify the obvious consequences of her speciality's earlier position
and why are we now at the point of having to re-invent a new generation of
childrens' expertise in every hospital?
The BMJ reports the Royal College of Surgeon's obtuse suggestions
for "interconnected systems of service providers, agreed thresholds for
transfer, and networks across boundaries". But as a profession we have
allowed the present situation to happen under our noses and the least the
College could do is own up to it.
Competing interests: No competing interests