Pressures on resources have raised questions as to whether the NHS should set limits on the amount of money spent on neonatal care, and whether it is necessary for doctors to continually push the boundaries in reviving younger babies.
Next month, a landmark report from an expert panel on neonatal care by the Nuffield Council on Bioethics is expected to reject calls for national limits on viability - in Holland doctors cannot revive children under the age of 25 weeks – arguing that babies must be treated individually.
However, debate among British doctors over the advantages of treating young children still rages, with babies born at 23 weeks routinely surviving. Dr Sandy Calvert, a consultant neonatologist at St George’s, said her own unit did not resuscitate 22-week-old babies, but she is aware that a hospital in north London does. “If you want my personal opinion, I think we should be concentrating on improving the quality of survival rather than trying to get younger and younger babies to survive.”
As well as medical advances which keep an increased number of babies alive, pressures on neonatal wards have also risen due to the IVF boom which causes a large number of multiple births. These are more likely to be premature. While adults and children in intensive care have one nurse per patient, the ratio for babies is generally two babies for each nurse.
October 2006 |