Many UK hospitals do not have sufficient staff or facilities to cope with increasing demand for intensive care in neonatal units, MPs have warned.
The House of Commons Public Accounts Committee says regional differences in death rates have continued, despite a reorganisation five years ago.
Recruiting and retaining skilled staff remained a "major challenge", it said. The government's "children's tsar" said funding had increased, and a taskforce set up to improve neonatal care.
The number of babies born requiring a cot in a neonatal intensive care unit is rising - 2006/07 figures suggest that one in ten babies born needs to spend time there. However, data from across England suggested that mortality rates were higher in some areas than others. In 2003, the 180 neonatal units in England were organised into 23 "clinical networks", with the aim that every region should have the right mix of specialist care. The public accounts committee report said that these changes had had only a "limited effect", and called on the government to act.
Edward Leigh MP, the committee's chairman, said: "Constraints in capacity mean the Department of Health is still struggling to meet the demand for neonatal services.
"The serious shortages of neonatal nurses must be addressed, and high occupancy rates in a third of units could have major implications for patient safety, owing to
increased risk of infection or inadequate staffing levels."
Tina Pollard, the chairman of the Neonatal Nurses' Association, said that many units still operated with one nurse for every two babies or worse, when best practice
suggested that a one-to-one ratio was needed.
Andy Cole, chief executive of the baby charity, Bliss, said: "It is clear that the National Audit Office and the public accounts committee have accurately identified what are the most urgent problems with the services that look after our most vulnerable babies.
"We need to take action now to ensure that babies in intensive care get the one-to-one nursing care they need and deserve."
June 2008
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