Volume 1

The regulation of private and other independent healthcare : fifth report / Health Committee.

  • Great Britain. Parliament. House of Commons. Health Committee
Date:
1999
Catalogue details

Licence: Open Government Licence

Credit: The regulation of private and other independent healthcare : fifth report / Health Committee. Source: Wellcome Collection.

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    CHILDREN 78. In evidence to us, representatives of the independent general hospital sector referred to the responsibilities of practitioners and MACs to ensure that hospital staff and support facilities promoted patient safety.'*? We sought to examine the extent and adequacy of such safeguards as they related to children’s health care in the light of written evidence from the Royal College of Paediatrics and Child Health. This indicated their anxiety over the standards of care provided to children admitted as private patients under the care of surgeons, anaesthetists and physicians who more generally treated adults. Their particular concerns were: ¢ The wide range of children involved, often including infants and toddlers. ¢ The growing number of children receiving private in-patient care. ¢ The failure to provide policies and protocols specified to the needs of children and equipment appropriate to their size and age. ¢ Poor pain management, and a lack of paediatric pharmacy support . * The fact that psycho-social aspects of the care of children were frequently ignored.'* 79. The RCN also referred to their long-standing concerns about the standards of care provided for children. These concerns had not been assuaged by a view, expressed in a letter to the College from the Department in January 1998, which included the comment that “the responsibility for ensuring that appropriate standards apply to children in the private sector must lie with the parents and those purchasing and providing the services”.'” 80. In our previous inquiries into children's services we found that there were particular difficulties even in the NHS in ensuring that children were attended to by appropriately qualified people.'** We therefore sought information from provider representatives about provision in their hospitals. They pointed out that they were governed by guidelines on the accommodation of children drawn up by the NHS Confederation for its registration and inspection officers'** and had also introduced their own guidelines for the treatment of children.'*? These providers also assured us there was always a trained children's nurse on duty in their hospitals.'*° 81. Supplementary written evidence from these witnesses indicated they recognized the importance of specialist skills and procedures in the care of children. The RCN also provided supplementary information, from a survey of independent sector hospitals. This presented a much more mixed picture. Some 109 questionnaires were returned from independent hospitals which provided services for children. Of these hospitals, 18% employed no children's nurses either as a “bank” nurse or on a permanent basis; 20% had no named paediatrician and a further 33% offered no paediatric anaesthetic cover. Some 6% had no 24 hour on-site resident medical cover. Almost half admitted children of all ages over one year.'*’ The survey did, however, also indicate that there were a number of individual hospitals with excellent resources for the care of children, including the availability of registered children’s nurses to provide direct hands-on care. 82. We note the reassurance that providers offered that particular attention is frequently paid to the importance of matching services to the needs of children, but we are not convinced that every child admitted to what are normally adult facilities is provided with direct and continuing care by nurses and clinicians with specialist qualifications in the care of children. We therefore welcome the response of the Secretary of State to our concerns when he offered us a “guarantee” that the Department’s forthcoming consultation would look specifically at the issue of special 199, 354. 140 Ev., p384. ‘41 bid. 142 Ey., p263. '3 Health Services for Children and Young People, Third Report, Session 1996-97 (HC 314), para 160; Hospital Services for Children and Young People, Fifth Report, Session 1996-97 (HC 128), para 119. Q355. Q356. Q357. PM 62B (not printed). 144 145 146 147
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