Children 'at risk' due to lack of doctors - 25/5/2006

link to The Times

Children 'at risk' due to lack of doctors
Cynthia Busuttil

St Luke's Hospital's paediatrics department is facing a "potential crisis" because of a lack of manpower that is putting children and babies at risk, the president of the Maltese Paediatric Association, Paul Soler said yesterday.

The situation is said to be so dire that the association convened an extraordinary general meeting last week to express concern about the standards of medical care and patient safety. It called on the health authorities to take immediate action. "It is imperative that the situation is rectified as soon as possible because patients' safety is at stake," Dr Soler said.

The situation, he said, has been bad for several years but it has worsened over the past few months.

Dr Soler told The Times that through the meeting's resolutions, paediatricians are warning the government that if an error occurs due to fatigue and poor working conditions, it will not be the individual paediatrician who would have to answer but the authorities.

He explained that if paediatricians are constrained to work for up to 24 hours at a stretch, on their own and without an adequate rest period, they will obviously become tired and are more likely to commit errors and misjudgements.

He explained that the whole paediatrics department is normally run by a single senior paediatrician, who often has to work for up to 24 hours at a stretch without adequate rest. Although there would also be junior paediatricians on duty, the Special Care Baby Unit (SCBU) can only be run by a senior paediatrician.

"This means that if there is an emergency in another part of the hospital, the senior paediatrician has to deal with two cases at once. This is of serious concern."

Dr Soler said that since 1994, the senior paediatric registrars have been insisting that at least two senior paediatricians should be present at the SCBU at any one time.

But this has never been achieved in 12 years. "Lately, because of the increasing number of patients being admitted to the SCBU, the increase in complexity of medical care and a rise in patient expectations, the workload has increased substantially. But the number of senior paediatricians on duty has remained the same," he said.

The paediatricians are also stressing the need for a complement of 12 senior registrars, almost double the existing seven, two of whom can opt out of night duty at any time.

To add to the association's concerns, the working conditions are also pushing paediatricians to think seriously about leaving the public service. "Unless working conditions are not improved, very highly trained paediatricians will look elsewhere for employment. The government is forking thousands of liri to train specialists only to lose them after a few years," he said.

Dr Soler said one paediatrician was recently lost to a British hospital and several others are seriously thinking of leaving the public service.

"They have absolutely no prospect of career progression, the salary is relatively low and working conditions poor," he said.

The Health Division was unable to answer questions sent to it by The Times yesterday and but is expected to do so today.

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