How many inpatient paediatric units do we need?

Abstract

In his article on paediatric inpatient units, Professor Taylor claims that many present paediatric units are too small to provide safe and cost effective care, do not meet required standards, and should combine into larger units providing specialist children's services.' We would disagree with him, at least with regard to rural communities. In many small district general hospitals a very high standard of care is offered, frequently directly by the consultant and often at great personal cost. The service shares many of the better aspects of primary care delivered by staff who know the families and their backgrounds. Professor Taylor stresses the value of a good relationship with the tertiary centres; where this exists children can be referred to superspecialists when indicated. He does, however, make a good case for continuing update and education for all staff and the need for clinical commitments to be such that study and development of appropriate skills are possible