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• Community Child Health in Crisis
  Chris Newman
  Published on: 23 August 2004

• Published on: 23 August 2004

  Community Child Health in Crisis

  • Chris Newman

  Dear Editor,

  Dr Mather in her article, Community Child Health in Crisis, states that in her opinion, the distinction between acute and community paediatrics needs to disappear. She is not alone in this view. I suspect very many paediatricians will agree with her.

  We all need a good basic training in paediatric medicine as a foundation for our work and for any special interest. There is already much o...

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  Dear Editor,

  Dr Mather in her article, Community Child Health in Crisis, states that in her opinion, the distinction between acute and community paediatrics needs to disappear. She is not alone in this view. I suspect very many paediatricians will agree with her.

  We all need a good basic training in paediatric medicine as a foundation for our work and for any special interest. There is already much overlap between hospital and community based programmes. The term “community” is ambiguous and means different things to different people.

  Many hospital- based paediatricians do outreach clinics or are involved with care of children in the community, whilst many community-based paediatricians do some general paediatrics or have on-call duties in the hospital. We are all involved in some way with child welfare, development, disability, child protection, and support for the family. It may be right that demand for services outside hospital is rising at a time when the number of community paediatricians is falling.

  Part of this increase stems from the fact that many children are now looked after at home when previously they would have been in hospital. Recent developments in paediatric training programmes and the European Working Time Directive have also caused acute pressures within our hospitals. Consultant workload has increased and in acute paediatrics consultants are finding themselves more exposed.

  There is an urgent need for consultant recruitment in many areas. We all need to work much closer together to deliver the service in the future. With the new contract for general practitioners it is also time to review the primary/secondary care interface. We need to understand the developing concept of Children’s Trusts and how they will fit in with present Child Health Services. We need to work closely with Primary Care Trusts to encourage development in line with the new National Service Framework for Children. We are in a time of great change and this brings with it great opportunities.

  I agree we have to base the future on the needs of children and not on our own career aspirations. We should accept the challenge and all move forward together.

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  Conflict of Interest:
  None declared.

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