Doctors push for child safety

The Ministry of Health is backing much of a wide-ranging safety agenda proposed to tackle what children's surgeons say is a "rapidly deteriorating situation" for New Zealand children.

The Society of Paediatric Surgeons, in a submission written last August but only presented to Parliament this week, has expressed "unprecedented concern at the increasing rates of admission for primary preventable conditions of a surgical nature in New Zealand children".

It said New Zealand had:

* The highest death rate in the OECD for accidents and injuries among children under 19.

* Ten times Australia's rate of hospital admissions for children with skin disease, with an increase from 150 for every 100,000 children in 1990-91 to 350 in 2006.

* Double the admissions rate for bronchiolitis (inflamed lungs) in 2006 compared with 1990-91.

* Six-month delays in Auckland for children needing stomach surgery to get adequate nutrition for brain development.

Wellington community paediatrician Nikki Blair said New Zealand was not acting on the main causes of child injuries.

"There are a lot of things we are not doing that other countries are doing that have addressed those high injury rates, such as speed limits around schools and car restraints being legalised for children up to 148cm tall," she said.

The submission said Sweden, Germany, France, The Netherlands and parts of Britain had achieved "enormous reductions" in death and injury by imposing 20km/h speed limits near schools and in other areas with high child populations.

New Zealand already requires full child car seats for children under 5, but the surgeons want this country to follow Britain and North America in requiring booster seats, lifting children up to a height where adult safety belts are effective, for all children up to 148cm - "at least" up to age 9 and "ideally" until 12.

Ministry of Health chief child health adviser Dr Pat Tuohy said he was not aware of any plan to legislate on the matter but he supported public education on the issue.

He strongly supported another proposal by the surgeons for local councils to enforce the law requiring swimming pools to be fenced.

Many houses for sale did not have fenced swimming pools."It makes me really cross."

The surgeons said many New Zealand children did not know how to swim, partly because 323 of the country's 2600 schools had closed their swimming pools in the six years up to last year.

Water Safety Council manager Matt Claridge said schools had been closing pools since teaching swimming was removed from the compulsory curriculum in 1998, and the council believed only 700 to 800 schools now had operational pools.

Dr Blair said the country's high rate of child skin infections and lung diseases reflected poverty which meant families could not afford after-hours medical care or hot water.

She said a Wellington region pilot cut skin infections by 20 to 30 per cent by simple measures such as using public health nurses to educate parents and schools about cleaning and properly dressing children's cuts and grazes.

"One of the points of intervention was improving the facilities in low-decile schools. Some didn't have hot running water," she said.

"There has to be free access to after-hours clinics for under-6s anyway.

"They are the most vulnerable to get sick."

SURGEONS' AGENDA
* 20 km/h limit around schools.

* Compulsory car booster seats for children aged 9-12.

* Raise the driving age.

* Enforce pool fence laws.

* Reopen school pools to teach children to swim.

* Public and school education on avoiding skin infections.

* Free after-hours healthcare for children under 6.

* Eliminate poverty so families can afford heating and hot water.

* Cut surgery waiting lists.