By Dr David Shortland Vice-president of the RCPCH
Boy in hospital Fifty children's wards 'might close'
Every parent wants the best care for a sick child.
But - as this government makes its first decision about restructuring hospital care - Dr David Shortland, vice-president of the Royal College of Pediatricians and Child Health says being treated further away from home might be necessary to get the best.
As changes within the NHS and the financial squeeze start to bite, hospitals are looking again at the affordability of keeping skilled pediatricians available on call 24 hours a day in small hospitals where there are similar services within about 30 minutes drive.
There are many units operating with dangerously low levels of staff, and trainee doctors being left to manage wards because there are just not enough senior consultants.
There is increasing pressure from the government to reconfigure children's services so that senior pediatricians are located in more specialist inpatient units, with smaller hospital wards closing or being converted to daytime-only units staffed by specialist nurses and visiting consultants.
It is likely that up to 50 of the existing 218 inpatient wards would need to close in the UK.
Many of these units will have experts on site to see children during the day rather than taking in-patients as they do now.
Although A&E departments don't only provide pediatric services, we are all aware that they are all under the same pressures.
Closures 'inevitable'
It is completely understandable that parents are worried about their local services moving away, but these changes are important so specialist units can achieve and sustain the necessary excellence and quality.
If we want our health service to protect health outcomes and safeguard children and young people, then parents have to face traveling further for treatment if their child needs an overnight stay.
As a parent, I would expect and want my child to have the highest quality care possible - and it is crucial the standards of care are not comprised in any way.
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If your local unit can't meet the minimum standards of care for your child - wouldn't you rather drive that little bit further to one that can?”
These changes will allow doctors and nurses to be more readily available to the sickest children whilst continuing to offer the local service for early diagnosis and observation.
The new changes proposed will ensure that children are seen by senior trainees and consultants with better expertise and experience in a set period of time.
It's also important to highlight that it is not just pediatric services that are feeling the strain on services - we have seen opinion divided over children's heart surgery centers in recent weeks.
The government is also considering reducing the number of units locally and focusing on the regional centers for providing better care and outcomes for patients with a decision to be made by the end of this year, and changes implemented in 2013.
No matter which units are under scrutiny, the quality of care must remain or it only right those who cannot meet minimum standards should be closed down.
But any change should be solely on the basis of ensuring that the right standards of care can be met and children's health is paramount, taking into consideration the implications of longer journeys and transport arrangements.
Closure and changes to children's services are inevitable, but the reasons should be completely about the quality of care and support so children get better.
If your local unit can't meet the minimum standards of care for your child - wouldn't you rather drive that little bit further to one that can?
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