June 17, 2008
Concerns Over High Rate of Neo-Natal Fatalities in Region
By ROB MERRICK
HEALTH chiefs have launched an inquiry into why many more new- born babies die in Merseyside and Cheshire than elsewhere in England.
The death rate in the region is around 20% higher than the national average, according to a report by a committee of MPs published today.
Now the Healthcare Commission has set up a neonatal task force to find out whether the deaths are the result of poverty - or poorer medical care.
Experts acknowledge that a complex range of factors - including social deprivation, smoking during pregnancy, ethnicity and older mothers - can explain why more babies are born prematurely and fall ill.
However, today's report by the powerful public accounts committee (PAC) also raises the alarm over a shortage of nurses and overcrowded special units in some areas.
Last year, neo-natal units were, on average, forced to close to new admissions once a week due to a lack of baby cots and a third operated above the recommended occupancy rate of 70% - increasing the risk of infection.
According to the PAC, the death rate in Merseyside and Cheshire was 3.6 babies per 1,000 births in 2005, the fourth worst record in England. The average was 3.0.
It said a 2003 reorganisation of neo-natal services into 23 networks - within which hospitals should co-operate on available cots - had failed to cut stark geographic variations in mortality rates.
And there was no requirement on Strategic Health Authorities to assess the performance of Merseyside and Cheshire and the other networks.
In evidence to the committee, the Department of Health (DoH) was unable to say whether variations in death rates were due to deprivation, or the quality of care.
As a result, the independent Healthcare Commission has asked The Royal College of Paediatrics to examine the data from each network.
John Pugh, the Southport MP who sits on the committee, welcomed the move, saying: "I am very concerned about the differences in mortality rates.
"We need to find out why Cheshire and Merseyside has the fourth worst figure.
Is it because mothers are not using ante-natal services, which is crucial to whether babies survive or not?"
Earlier this year, the firstever comparisons of maternity units praised services in Merseyside, with Arrowe Park Hospital, in Wirral, given the top classification of "best performing".
Today's report also highlights how only half of networks provide specialist neo-natal transport services 24 hours a day, seven days a week.
Nearly three-quarters of units reported delays in transporting babies - and 44% believed that care had been compromised as a result.
Newborn babies were most likely to die in the Southwest Midlands (a mortality rate of 4.8 per 1,000) and least likely to in Surrey and Sussex (1.8 per 1,000).
About one in 10 babies born every year - 62,471 in 2006-07 - needs specialist neo-natal care, because they were born prematurely, have low birthweight, or conditions such as a heart defect.
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