Survey highlights regional inequalities in care of sick children

3.30pm

Sick children are receiving markedly different care in different parts of the country, according to a survey released by the Paediatric Society of New Zealand today.

Speaking at the society's annual scientific meeting in Queenstown, society president Dr Nick Baker said while some boards were grappling with the issues, others were "slipping backwards".

The questionnaire, which was sent to all health boards, was designed to gauge how well boards were doing with national policies and strategies to improve child and youth health.

Auckland District Health Board -- which runs the national Starship Children's Hospital -- received one of the lowest scores, but this was largely because it did not fill out the survey on which the scores were based.

Wairarapa received the same score as Auckland, with South Canterbury coming last of all health boards.

Waikato and Counties Manukau received the top score.

Dr Baker said the findings showed "marked differences in performance between boards" and the gaps were widening.

The key problem was that central Government formulated policies, but their implementation was now often left to individual boards.

"Some boards are working hard to put them into action while others are making little effort," he said.

"Local implementation is dependent on DHBs assigning funding, which only happens if they consider them a priority.

"Inevitably inequity is increasing."

Many excellent initiatives -- such as the child and youth mortality review, Well Child Information Systems and Child Protection Services -- were at risk if they were starved of funding, he continued.

Following the killing of four-year-old James Whakaruru by his stepfather in 1999, a report made a number of recommendations regarding systems and processes to manage child abuse.

While it was pleasing to see that all DHBs had a child abuse policy, he noted a number were still only in draft form.

Further more, it was "disappointing" to note that only two DHBs ensured staff had training around child abuse policy on a mandatory basis.

He was also "alarmed" to see that very few DHBs were collecting the information needed to determine the current levels of inequity in health status.

Another area of concern was the shortage of well-trained and experienced nurses, the lack of national benchmarking for skills, and the number of children being cared for in adult wards.

"Some DHBs also accommodate adult patients in children's wards as a matter of course.

"This is equally unacceptable," he said.

In areas where there has been progress, he noted the establishment of eight Child and Youth Committees, with another four planned; the appointment of community paediatricians, and specific initiatives in annual plans to improve child and youth help.

"We hope these good intentions are turned into action."

Dr Baker said many paediatricians in Auckland were "extremely frustrated" with the way in which the board dealt with issues regarding services for children and young people.

Speaking on National Radio this afternoon, he said Auckland DHB's inability to provide a coordinated response to the survey was indicative of underlying problems.

"I work closely with a number of specialists in Auckland who are extremely frustrated with the performance of their local district health board.

"When informed that they were the only DHB in New Zealand that was unable to complete the questionnaire, they didn't feel it was anything of a surprise."

- NZPA