Of all the
Medical Negligence cases that I have done over the years the most distressing are
those that relate to child birth and neonatal care. This should be a time a
celebration and in the vast majority of cases it is. There are however those
rare cases where something goes wrong. I have seen cases where babies suffer
tragic brain injuries due to lack of oxygen and suffer life long disabilities. These
cases are few and far between but when they happen the consequences are
devastating.
If there is
any area of medicine which should be given a top priority it is this.
There are proposals
from one expert that there should be a small number of ‘centres of excellence’
with a strong concentration of consultants to ensure the best possible care.
The idea is
to reduce the number of obstetric departments and concentrate the funding in
larger centres that are able to offer high quality care. It sounds good. Who
would object to improving care?
But there
is also a downside. Fewer centres inevitably mean closure of units and the loss
of local facilities. It does not seem that long ago that the community midwife
visited mothers on her bike and was there when the baby was delivered at home. So
will the loss of local facilities mean a less personal service? This is the concern
of Mary Newburn from the National Childbirth Trust –
"We are concerned that very large hospital units can
seem like baby factories to parents: impersonal and preoccupied with pushing
mothers and babies through the system, that people are processed like
components in a factory, and that some don't get personalised care."
This is a finely balanced argument. I can see the concerns
of mothers who feel that they will lose a locally available service. Some may
have to travel long distances. On the other hand I have seen the terrible
consequences of things going wrong which suggests that anything that improves standards
is a good thing.
I have to say that my concern is that this will all be about
saving money. Closing units is associated with cuts. And if the welfare of the
newborn is placed at risk for economic reasons then the proposals should be vigorously
opposed. The final decision should be with local health providers to decide the
best means of providing care in their area.
Such decisions should not be left to politicians.
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