We have shown that the critically ill neonate may be safely transferred over long distances provided some essential criteria are fulfilled. There are obvious advantages in centralising neonatal surgery in a limited number of regional centres where surgical expertise and adequate support services are concentrated and there seems to be no justification, except in situations of dire emergency, for neonatal surgery to be performed in district general hospitals in the United Kingdom. The fact that neonates requiring surgery can be safely transferred adds strength to the plea for the paediatric surgeon to have an absolute monopoly of surgery in this age group.
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