NHS ‘superior’ for us and our children
Dr Mair Parry, officer for Wales for the Royal College of Paediatrics and Child Health (RCPCH), highlights how child healthcare has changed for the better since the NHS was established
Significant advances in technology, developments in medicine and the creation of dedicated hospital units have greatly improved the health of children in Wales.
The National Health Service is something that Wales and the UK as a whole can be proud of. And as a paediatrician I for one see first hand each day the impact it has on children, young people and their families.
Just last year the UK was ranked as having the best health service in the world by an internationally respected panel of experts from the Commonwealth Fund.
The experts rated the care delivered by the NHS as superior, even when compared to countries that spend more on their services.
Of the 11 countries studied, the NHS scored highest on quality and on access and efficiency – we do after all offer a health service which supports us at our greatest time of need.
We know we can see a doctor at any time, day or night, and we know that it isn’t going to cost us anything – unlike our friends in the States.
Many families live in fear of becoming ill due to the crippling cost of healthcare. It’s the leading cause of bankruptcy in the USA.
The reputation of the UK’s health system has grown gradually since its conception in 1948 – but it hasn’t always been this way. also grown considerably since the birth of the NHS, with the evolution of paediatric intensive care in the late 1990s.
Children were once treated on the same wards as adult patients. Now children have their own dedicated units.
When a child needs to move from one hospital to another, they are now transported by specialist teams, whereas previously local teams with limited up-to-date experience in intensive care would move them.
This complete replacement of the transport service has been life-saving.
Once a child has arrived at a paediatric intensive care unit, the tools used to treat them have also moved on.
Significant technological advances have led to the development of sophisticated ventilators, renal replacement therapy used to treat kidney failure, for example, and heart monitoring.
Intensive care units can now even be supervised via tele or remote intensive care unit (ICU) systems, providing surveillance and support to a large number of ICUs in distant or remote sites by a centralised multi-disciplinary care team.
Children in South, West and Mid Wales have these first-class services in Cardiff, and for those living in North Wales, Alder Hey, in the north west of England, is their closest unit. Thankfully childhood cancer is rare, with an average of 1,600 new cases every year in the UK, but the care of cancer is something that has improved greatly over the years.
There are several factors that have contributed to this overall improvement. Young children are often much more resilient than adults.
Children are programmed to grow and develop, which means they are better able to endure and repair physical damage. This means that they can tolerate much higher doses of chemotherapy and radiotherapy, leading to enhanced responses.
The creation of specialist centres across the UK which see children travelling to a hospital which provides expert care with expert equipment has also played a huge part.
Alongside all of this, research continues to underpin improved survival rates, allowing the exploration of novel targeted therapies. When a baby is born they are screened for a number of rare conditions.
Most babies screened will not have any of the conditions they are tested for, but for the small numbers who do the benefits of screening are enormous.
Early treatment can improve their health and prevent severe disability or even death. Positively, since the beginning of this year, the number of rare conditions being tested has increased. This means a total of nine conditions are screened for. same way Paediatric Intensive Care Units have.
We need to make sure children are seen by the appropriate doctor who can see them quickly and assess them properly. This means ensuring a child only goes to A&E when it is an emergency,and when it isn’t they use other services such as pharmacists and GP surgeries. Utilising all services available and ensuring children are seeing the right clinician, at the right place and at the right time, relieves pressure on frontline services and provides an extra layer of future proofing for our NHS.
We’re lucky in Wales in that the Welsh NHS is safe from private firms coming in and splitting up our children’s services – unlike our English neighbours, who are now faced with 70% of firms taking on the running of services that cover every aspect of the patient journey including diagnosis, treatment and on-going healthcare.
Just last year it was reported that as a result of privatisation of one hospital, inadequate hygiene standards and patient neglect were uncovered as companies put profits before patients. Although “superior”, the NHS still has some way to go if it is to meet the needs of a 21st-century population.
Despite having a world-class NHS, health outcomes across the UK are among the poorest in Western Europe.
As the RCPCH’s manifesto highlighted in the Western Mail just last month, Wales continues to have the worst rates of childhood obesity and smoking during pregnancy in the UK – although policies such as a ban on smoking in public places, restrictions on advertising and a ban on smoking in cars carrying children have contributed to a shift in culture.
Healthcare services such as children’s specialist mental health servic- es are under severe pressure, with referrals doubling over the past four years.
Child death rates in the most deprived parts of Wales are much higher than in the least deprived.
Poor death rates were the only, but very serious, black mark against the NHS from the Commonwealth Fund study.
With devolved powers in Wales, we are able to address these challenges and implement policies quickly – something that can’t be said for our English neighbours.
So it is important that as we move into the election period, that politicians recognise this position and grasp this opportunity with both hands to improve health outcomes for children. Wales has the most comprehensive review into child deaths in the UK.
It identifies and describes patterns and causes, and poses solutions to these issues.
This is very reassuring in our fight to reduce child death rates. However, there are policies that the RCPCH can recommend now, with one from its manifesto being the introduction of a 20mph speed limit in built-up areas – road traffic accidents are a major cause of preventable death in Wales.
Another 21st-century issue for Wales is childhood obesity. Just over a quarter of children in Wales are overweight or obese, so to fight that a policy that must be considered is a tax on food and drinks that are high in sugar, salt and fat.
RCPCH’s public polling showed about half of Welsh adults support this. In addition, compulsory PSE in schools to tackle issues around healthy lifestyles, mental health, bullying, sex and relationships must be introduced.
With the 2016 election looming, and with the devolved powers they have, politicians have a real opportunity to show their appreciation of our “superior” health service by committing to safeguard its future.
They can do this by investing early to prevent ill-health and being open to evolving our health system to meet the demands of a 21st-century nation.