Doctors urge ministry to take lead in neonatal care

The Health Ministry needs to play a greater role in planning the use of hospital beds and specialist staff to care for the country's sickest and most premature babies, doctors' groups say.

The ministry this week released a review of neonatal intensive care services which showed New Zealand hospitals had at least 18 too few level-three cots, based on international benchmarks.

Level-three cots care for the sickest babies. There are six level-three neonatal intensive care units (ICUs) around the country.

A shortage of beds means that on several days each month many of the units are full, forcing mothers and their sick babies to be flown to hospitals in other parts of New Zealand. Often they then have to stay there for several weeks until their baby is healthy again.

Paediatric Society president Nick Baker said one reason for the shortage of beds was the way the service was structured.

Most level-three neonatal ICUs were administered by a single district health board, but took patients from other DHBs, making funding decisions difficult.

He said the Health Ministry needed to ensure DHBs were working together to make sure all the units had sufficient cots and staff.

"It's often hard for a health board to decide to pay to increase the capacity of a unit when they are not immediately getting money from the other health boards," he said.

"At the moment it's still quite fractured. That's where the ministry has a role of getting them to work together."

He said most units were moving to boost their cot numbers - pushing numbers up by about 20 in the next five years - which would alleviate some of the current demand.

However, demand was continuing to rise as more women gave birth later in life, leading to more complications, and more sets of premature twins born as a result of IVF treatments.

The Association of Salaried Medical Specialists said the ministry needed to show more leadership.

Executive director Ian Powell said in a statement there was "plenty of analysis" but practical measures were called for in the face of a problem which was escalating towards a crisis.

But ministry child and youth chief adviser and review author Pat Tuohy said the ministry had been involved in co-ordinating planning and funding of neonatal ICUs for several years.

The review went a step further by providing an accurate picture of unmet and future need around the country, effectively reminding DHBs of their obligations and their responsibility to work together to meet that need. The ministry would work with them to try to ensure theydid so, Dr Tuohy said.

He believed the 20 additional beds would raise ICU capacity to an internationally acceptable level.

- NZPA