Staff shortages causing neonatal units in Scotland to turn away new admissions

Specialist services for babies in Scotland’s hospitals are overstretched and understaffed according to a new report by the premature baby charity Bliss. It says a lack of staff means neonatal units regularly have to be closed to new admissions.

Andy Cole, Chief Executive, Bliss, told Good Morning Scotland, “These are very specialised hospital units that look after the smallest, the sickest, the earliest born babies in Scotland. That could be anywhere down to 23 or 24 weeks of gestation, babies maybe a pound or 2 pounds in weight in some instances.”

Mr Cole said the report had highlighted a shortage of 140 highly qualified and specialised neonatal nurses. This meant that “minimum standards of clinical care” could not always be met and units often had to close their doors to new admissions. Babies then had to be transferred to other units, often involving long journeys, he stated.

He said the Government had made some “very welcome, small, positive steps” to improve the situation but there needed to be a “step change” in recognising that neonatal services were a priority area requiring greater investment.

EDM 2370 was also tabled in Parliament in response to the Bliss Baby Report 2008 on 29th October. It states:

That this House welcomes the release of the Bliss Baby Report 2008; recognises the hard work put in by staff in neonatal units across the country; praises the campaigning efforts undertaken by Bliss to raise awareness of neonatal healthcare issues; is deeply concerned by the desperate shortage, highlighted in the report of specialist nurses in neonatal care units; further recognises the stress and anxiety that staff shortages and lack of adequate treatment capacity in this area creates for staff and parents alike; is worried by the high transfer rates of sick and premature babies to other units due to lack of capacity; calls on the Government to push not for minimum standards, but for the best possible standards in neonatal care throughout the NHS; and in particular calls on the Government to take all necessary measures to ensure that the minimum nursing levels recommended by the British Association of Perinatal Medicine are adhered to.

Government announces plans for primary school children to be given compulsory sex and relationship lessons

Setting out the findings of a government review into sex and drugs education, schools minister Jim Knight said the lessons would be compulsory for those aged between five and 16. The review was started after concerns were raised that teaching in the subjects was too patchy. Under the proposals, children will learn about parts of the body and the effects of drugs from age five, and will have lessons on puberty from the age of seven. Knight said he wanted “to be clear we’re not talking about five-year-olds being taught about sex”.

But he said that personal social and health education (PSHE) “should be supported by a statutory programme of study in order to give it an increased status in schools and with school leaders”.

He added: “At Key Stage 1 [children] will be learning about themselves, their differences, their friendships, how to have strong friendships and how to manage their feelings. That then allows them in Key Stage 2 to learn about puberty and then about the facts of life, all these sorts of matters.”

The Department for Children, Schools and Families said the review identified “a need to challenge the perception that sex and relationships education happened in a ‘moral vacuum’ in schools”. And it recommends that teachers are given specific training, with all schools in England following a “high-level programme of study”.

Study finds light drinking in pregnancy is not bad for children

Research published this week by University College London suggests that children born to mothers who drink 1-2 units per week or per occasion are not at increased risk of behavioural difficulties or cognitive deficits compared with children of abstinent mothers.

The study data shows that boys born to mothers who drank lightly were 40 per cent less likely to have ‘conduct’ problems and 30 per cent less likely to have hyperactivity, even when a range of family and socioeconomic factors were taken into account. Boys born to light drinkers also had higher scores on tests of vocabulary and whether they could identify colours, shapes, letters and numbers compared to those born to abstainers. Girls born to light drinkers were 30 per cent less likely to have emotional symptoms and peer problems compared with those born to abstainers, although this appeared partially explained by family and social backgrounds.

Confirmation on money allocated to Return to Practice Programmes for midwives

A question was raised in Parliament this week about what consideration has been given to providing support for participants who commenced re-training under the Return to Practice Programme for midwives in the financial years 2006-07 and 2007-08.

In response, Ann Keen, Parliamentary Under Secretary of State for Health responded that Strategic Health Authorities (SHAs) were responsible for allocating resources from education and training funding to support local initiatives such as return to practice programmes for professional staff. She noted that the Department has provided support and funding to SHAs for a programme of work, to deliver expansion in midwifery capacity, as announced in February, including supporting midwives through return to practice, where this is part of the local recruitment programme.

She also emphasised that SHAs are managing Return to Practice programmes locally and have been allocated £1.5 million in 2008 or £3,000 per midwife. The £3,000 is an approximate cost per midwife to provide free training, and to support costs such as for childcare and travel.

200 babies due to be born to prisoners this year

The Liberal Democrats revealed new figures showing that the number of babies born to mothers in prison is due to double to 200 this year.

The information, contained in a Parliamentary answer, shows how:

• Between April 2005 and July 2008, 283 children were born to women in prison
• This is a rate of 1.7 births in prison per week in England and Wales
• 23 births were to mothers aged 18 and 19
• Between April 2008 and June 2008, 49 women in prison gave birth, at a rate of nearly four a week
• If that rate continues, nearly 200 women in prison will give birth this year

Commenting, Liberal Democrat Justice Spokesperson, David Howarth said: There can be few worse starts in life than being born in prison. Labour’s obsession with looking tough has led to a near doubling of the number of women in prison in the last decade. Not only should there be fewer women in prison but smaller prison units, closer to home, would surely be a more appropriate environment to bear and raise children than exists in prison today.’

Michael McGimpsey announces plans to review maternity services in the Greater Belfast area

The Eastern Board will take forward the review which will look at existing capacity and the immediate pressures faced by maternity services in Belfast and the surrounding areas. The board will work with the Belfast and South Eastern trusts to consider how best to develop inpatient obstetric services and examine how consultant-led services will be appropriately supported by specialist paediatric services.

The minister said that maternity services in Northern Ireland currently face a number of challenges. With an increasing birth rate across Northern Ireland, particularly evident in the Southern Trust area and in the east of the province, maternity services must be developed to meet some of the immediate pressures.

He also stated that whilst existing maternity and children’s hospitals in Belfast need to be modernized, there is only a capital budget of £3.3 billion, less than half of what is needed to take forward the infrastructure projects that are considered a priority. He assured the public he would be raising this issue with his Executive colleagues as a matter of urgency.

During his speech he said that he recently announced extra £3.5million for Craigavon Area Hospital, to help expand maternity services in the area, an additional 12 midwifery students, dedicated to supporting maternity services in the Southern Trust, and £500,000 to improve maternity services at Daisy Hill hospital. He stated that this would enable Craigavon Area Hospital to deliver up to 200 additional births on top of the 300 additional births announced earlier this year.

He also noted the opening of the new £13million Maternity Unit at the Ulster Hospital in Dundonald in October 2007, which is capable of accommodating an extra 1,000 births per year.

Referring to maternity services in Lisburn and the proposal by the South Eastern Trust which would see inpatient obstetric services transferred to other hospitals while retaining antenatal and postnatal care at Lagan Valley, the minister said:

“I want to make it clear that Lagan Valley Hospital will continue to make a valuable contribution to health service provision to the local community. As part of its review, I have asked the Eastern Board to consider the potential for a midwife-led maternity service for Lisburn.”

“The hospital has a bright future ahead. That is why I am investing £3.5million in new operating theatres. This funding underpins the hospital’s role as a key local hospital. It will be a specialist centre for planned surgery for Greater Belfast and continue to provide a wide range of diagnostic and treatment services for local people including important services for women during and after pregnancy.”

Health Committee hears from early years and maternity service representatives on health inequalities

Long-term strategies and resources were needed if the Government was to address the cultural and generational issues surrounding health inequalities, MPs heard today. The Health Select Committee as part of it inquiry into health inequalities today heard from the following witnesses:

* Christine Bidmead, Centre for Parent and Child Support, South London and the Maudsley NHS Foundation Trust

* Professor Jane Sandall, Professor of Midwifery and Women’s Health, Division of Health and Social Care Research, King’s College London

* Professor Kaye Wellings, Professor of Sexual and Reproductive Health, London School of Hygiene and Tropical Medicine

Opening the meeting the Chair and Labour MP, Kevin Barron, asked the witnesses what they thought were the most important issues in early years services that would help address health inequalities. Key points raised included:

* Increased emphasis on combating post-natal depression and the impact that it has on children’s development.

* The importance of giving teenage mothers counselling and contraceptive advice if they were to help them avoid the increased disadvantage of having a second child.

* The importance of education in breaking the cycle of intergenerational disadvantage

When asked about what could be done to help improve breastfeeding rates in the UK, Prof Sandall said that measures that had been proved to work need to be implemented. She noted that NICE, the Breastfeeding Alliance and training programmes for nurses could all play a part in this and that breastfeeding programmes should become more widespread across hospitals.

The role of health visitors and their impact on health inequalities also came into question with comments emphasizing the positive relationship they build with new mothers and the important role they play in making a holistic assessment of the needs of the whole family. Ms Bidmead confirmed that services were stretched and that some would not be able to make the repeated visits to families that would enable them to establish a proper relationship.

When asked if targeted intervention initiatives such as SureStart had impacted on this Ms Bidmead said the PCTs had seen health visitors as an easy place for cutbacks as they had not been required to meet any official targets on them. As a result of this, she said less health visitors were being employed and less training places had been commissioned. She also highlighted that deprived children in more affluent areas should not be ignored and that they needed to identify cases of post-natal depression and similar.

When asked whether it was a lack of education on the parent’s part that exacerbated health inequalities, Ms Bidmead acknowledged this could be a factor but highlighted that they also had to consider the parents’ own upbringing and mental health.

Department for Work and Pensions launches new scheme for parents of poverty stricken children

Child Poverty Minister, Kitty Ussher launched a new pilot scheme aimed at helping parents of children in poverty getting back into work, stating that the Government remained committed to eradicating child poverty.

The new initiative, rolled out to ten authorities, will enable parents to access Jobcentre Plus personal advisers in Children’s Centres to enlist upon work focussed services. The pilot, which will run in 30 children’s centres from January 2009, will also test what other services could be beneficial in moving parents into employment. It complements the existing initiative of providing tax credits advice through Children’s Centres, which is being expanded following a successful pilot earlier in the year.

The ten Local Authorities chosen to test the impact of embedding Jobcentre Plus services in children’s centres are: Westminster, Lambeth, Nottingham City, Southampton, Sandwell, Redcar and Cleveland, Somerset, Blackpool, Kingston Upon Hull and Ealing.

Research claims ‘child poverty is costing the UK billions’

The Joseph Rowntree Foundation (JRF) has published new research which claims that child poverty is not only causing extreme hardship, but is imposing a large cost on taxpayers and reducing the UK’s economic potential. The report has estimated that child poverty costs at least £25 billion each year in losses to the Exchequer and in reduced GDP.

The research is based on economic modelling and provides two detailed calculations that make cautious estimates of some of the measurable financial costs from the fallout of child poverty.

A first calculation estimates the extra money that the government spends addressing the effects of child poverty. Research shows clearly that children from low-income families experience disadvantage in education, health and family life. This requires extra spending, for example on social services, to help overcome these circumstances. It can also trigger extra spending on law and order because the pressures of poverty and disadvantage can contribute to poor family-functioning which in turn is associated with a higher rate of anti-social behaviour. Based on the higher amount of social spending in areas with high child poverty, the study estimates that child poverty is associated with at least £12 billion in public spending on services.

A second calculation estimates the longer-term economic cost of the damage inflicted on those who grow up in poverty. As adults, there is a reduced chance of working and an increased likelihood of being in low-paid jobs. The study estimates that this is costing the Exchequer £2 billion a year in extra benefits paid to adults who grew up in poverty and are now out of work. Child poverty is also diminishing UK GDP by at least £11 billion through reduced earnings of those in work, £3 billion of which would have gone to the Exchequer in taxation.

Government to reassess the introduction of legislation to extend flexible working

It has been reported that the Government is to reassess whether, as a consequence of the economic downturn, it can delay the introduction of its legislation extending flexible working as a way of providing support to British business. The legislation includes the extension of the right to request flexible working to parents of older children and paid maternity leave.

The TUC has responded by claiming that the move would not save ‘a single job’. Its General Secretary, Brendan Barber, claimed: ‘Postponing a simple right to request flexible working would not save a single job in the small business sector. If such a request harms the business, the owner can say no. This would be an astonishingly irrelevant response to the severe economic downturn that we face and, in addition, would run the risk of sending a message to working parents that the Government is not on their side.’

Patricia Hewitt, the former Cabinet member who introduced the law on flexible working which gave parents of young children the right to request different working hours when she was Cabinet Minister for Women and Secretary of State for Trade and Industry said that she thought it was sensible to look at the impact as more flexible working and people reducing their working hours could be a real help in times of economic downturn. “It makes much more sense for an employer to say to employees would any of you like to reduce your working hours instead of thinking who am I going to make redundant … we know there are quite a few full time workers who would prefer to work maybe a three or four day week … and … enlightened employers have been responding to that sort of request for some time now.”