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Doctors crisis at hospital named in Baby P report
Andrew Gilligan and Sophie Goodchild13 May 2009
A shortage of children's doctors in the NHS could trigger another Baby P tragedy, it was revealed today.
London's Great Ormond Street hospital, which runs the child protection clinic where the toddler was treated, said it needs four times as many consultants as it had at the time of the child's death.
But leading children's hospital, which manages St Ann's Hospital, Haringey, said it was struggling to recruit enough paediatricians.
The admission comes as health watchdog the Care Quality Commission (CQC) today issued a scathing report about the NHS's “systemic failings” in the Baby P case including “inadequate staffing levels.”
A key recommendation of the inquiry is that hospitals including Great Ormond Street must have enough paediatric staff available.
The watchdog is critical of the fact there were just two consultant paediatricians at St Ann's when Baby P was seen in August 2007 and both were temporary locums.
Baby P died two days after one of the overstretched locums at the clinic sent him home, failing to notice that he had a broken back.
Great Ormond Street told the Standard funding was now being sought for a total of nine consultant paediatricians at the clinic.
But spokesman Stephen Cox said paediatrics was a Cinderella' service and the hospital was not able yet to make all the changes recommended by the CQC.
He said: “We know we've not done everything we think we need to do and we wouldn't dispite the service was understaffed. It was a matter of funding which was not within our control. We're seeking funding for a total of nine consultant posts.
It's hard to recruit paediatricians and takes time- working with deprived children is very important work but it's a hard job. It's a Cinderella service and we've got lots of people wanting to be brain surgeons but not paediatricians.'
Baby P was found dead in his blood-spattered cot in his mother's home on 3 August 2007 just days after locum paediatrician Sabah Al-Zayyat failed to spot his life-threatening injuries.
Great Ormond Street today defended its decision to recruit her, a decision they said had been backed by the Royal College of Paediatrics and Child Health.
But it revealed she had been hired to work at St Ann's because the hospital was unable to find a permanent children's doctor.
Mr Cos said: We hired a locum because we could not get anyone to work there (at the clinic) permanently. If you hire a locum you are stepping down in terms of expertise. But an external assessor from the Royal College of Paediatrics and Child Health said she (Dr Al-Zayat) had enough experience for the job (to become permanent). We never thought she was going to be the world's most experienced paediatrician but we would not have hired her if we didn't think she could do the job.'
As the Standard revealed yesterday, all four of the permanent paediatricians at the clinic felt they were driven from their work after they signed a joint letter, the year before P's death, warning that understaffing was putting vulnerable children at “very high risk.”
Great Ormond Street's statement vindicates the concerns raised by the four consultants.
In their letter, dated June 2006, they accused Great Ormond Street and Haringey management of “trivialising” and failing to act on their complaints about understaffing and warned that there was often “no child protection follow-up” of patients, such as Baby P, identified as potential abuse victims. They described this as a “very high risk” to children's lives and safety.
Dr Sethu Wariyar, one of the consultants, told the Standard: “There was this system of shifting blame to others, rather than addressing the issue. The managers completely buried it and refused to bring the problems out.”
According to the serious case review of the Baby P case, delays in getting a follow-up appointment at the clinic did indeed prove a crucial factor in his death. As early as March 2007, Haringey social workers asked the clinic to assess if there was an innocent reason for P's injuries.
But it took more than four months to get P a “long-awaited” appointment and it only happened when he was days from death.
Reader views (7)
Let this child R I P you all done a good job dont you!EXCUSE THATS ALL THIS IS!
- Essex Flower, barking essex, 14/05/2009 19:36
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Nine consultant posts! My husband, the Consultant Paediatrician at St. Ann's Hospital had to cope for 12 years on his own!!!!! Looking after 40,000 children when the maximum safe limit was 10,000. In all the years he worked there he never had an incident like this.
The management was abysmal and he pointed out year upon year what needed to be done but they did nothing. In fact they never did a thing! All they did was give themselves more managers to run the service. Lots of chiefs not enough Indians. The chiefs were very poor quality.
- Mrs Susan Heather Lingam, Potters Bar, Hertfordshire, UK, 14/05/2009 18:36
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every time i see poor little baby P-s picture I either cry of want to. And I am male.
I sometimes yearn for the baby to come back to life and we and my wife adopt him.
I hope in heaven he is safe and smiling all the time.
- Jaberwokie3, switzerland, 14/05/2009 18:36
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Sack 90% of the managers and use the savings to employ more doctors.
- R.F., Yorks, UK, 14/05/2009 18:36
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THIS KID WAS SEEN BY A FEW DOCTORS AND THEY WHERE SO PATHETIC THEY DID NOT DIAGNOSE THIS CHILD PROPERLY THE POOR SOUL IS GONE FOR GOOD WHILE THESE SO CALLED DOCTORS LINE THERE POCKETS WITH TENS OF THOUSANDS OF POUNDS FOR A SALARY WHAT IF THE NHS EMPLOY MORE OF THESE SO CALLED DOCTORS WILL OTHER KIDS GO THE SAME WAY THE NHS NEEDS TO GET IT ACT TOGETHER IT IS NOTHING SHORT OF A JOKE THEY NEED TO WEED THESE DOCTORS OUT AND PROSECUTE THEM IF THEY CANT DO THE JOB THEY SHOULD NOT BE THERE I COULD TELL YOU A LOAD OF HORRENDOUS STORIES ABOUT OTHER PEOPLE BUT THATS FOR ANOTHER DAY
- James Fennessey, london, 14/05/2009 18:36
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Get rid of the managers, middle managers and employ more doctors and nurses.
- Patricia, LONDON, 14/05/2009 18:36
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4 months to get a follow-up appointment with a consultant... this is a WAITING LIST.
Waiting lists come about because of RATIONING which is an inevitable consequence of CENTRAL PLANNING of provision.
The NHS is monstrous and should be dismantled. A system of much smaller regional providers would provide some choice and quality would improve without the need to spend billions on target planning and monitoring. The planning is always instantly out of date.
Lots of people find it unpleasant to equate market forces with healthcare but there is a link between choice and quality care. When are we going to stop kidding ourselves? The NHS is a beautiful ideal but a single centralised provider will never work efficiently. Split it up!
- Mark, London, 14/05/2009 18:36
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