Belfast Telegraph

Looking away is just not an option

Lisa Smyth asks: Are children safe in our hospitals? Or is it time for radical action?

There is nothing more harrowing than losing a child. But that agony is compounded further when the death happens in hospital.

So it is hardly surprising the pseudomonas outbreaks in the neonatal units at Altnagelvin Hospital and the Royal Belfast Hospital for Sick Children - which claimed the lives of four tiny babies - made national headlines earlier this year.

Parents across Northern Ireland - expectant mums in particular - were rightly horrified and demanded to know what had gone wrong.

Health chiefs moved quickly to allay fears, offering reassurances to pregnant women that our hospitals were safe environments for their babies.

But a subsequent independent interim review of the outbreaks, published last month, was highly critical of the handling of the outbreaks.

The author of the report, Professor Pat Troop, even went so far as to suggest that the deaths of some of the babies may have been prevented if health bosses had acted sooner.

Professor Troop's comments were stinging, but was it really such a surprise that she identified failings that may have contributed to the deaths?

The Belfast Health and Social Care Trust went public with the outbreak at the Royal on January 20, when it announced that it was closing the neonatal intensive care unit temporarily to allow a deep clean to be carried out.

However, the first baby had died two weeks before - on January 6 - the second on January 14 and the third on January 19.

The obvious question to everyone was: how could so many young lives have been lost before action was taken? Surely one tragic death was sufficient to warrant such action?

But it was explained that the very nature of neonatal intensive care units means patients there are extremely ill and susceptible to infections.

It is a sad reality that some of these babies do not survive. Furthermore, an outbreak is only declared after two cases of an infection are identified.

While this may have been the procedure at the time, it all seemed so clinical, so cold - inadequate, even - given that babies' lives were at risk.

It became even more alarming when it emerged that official guidance was sent to all trusts regarding the danger posed by pseudomonas and the link to basins and taps a number of times in the months leading up to the outbreak at the Royal.

If they were aware at the time of the first death that the most likely source of infection was the water system, why did they not immediately test the taps for the presence of the killer bacteria?

This question carries even more weight now with the publication of the Troop review and an acceptance by the trust's medical director, Dr Tony Stevens, that lives may have been saved if they had acted sooner.

The Troop investigation is ongoing - she will present her final report to Health Minister Edwin Poots at the end of May.

Until then, health bosses are in the process of implementing a list of recommendations already made by Professor Troop.

While all this happens, an independent inquiry is looking at the hyponatraemia-related deaths of five children in Northern Ireland hospitals between 1995 and 2003.

Hyponatraemia is caused by too much fluid in the body, which, in turn, causes the brain to swell and can lead to death.

The inquiry is currently looking at the case of four-year-old Adam Strain and the evidence so far has been shocking.

The youngster died after an unsuccessful kidney transplant at the Royal Belfast Hospital for Sick Children in November 1995.

Last week, a hushed court listened as the anaesthetist looking after Adam during his surgery admitted he caused the condition that led to his death.

Later he said: "I want to say that, in my view, Adam was a very brave little boy. He trusted me and I let him down and for that, I'm very sorry."

Clearly, we cannot predict the outcome of the inquiry, but it is obvious from the evidence presented so far that something went wrong during Adam's transplant.

Nothing can ever bring back the children who have lost their lives in our hospitals, but efforts are being made to find out what caused the deaths and the investigation by Professor Troop and the Hyponatraemia Inquiry will no doubt make a series of recommendations on how to improve the health service.

But with shrinking budgets and staff being stretched to the limit, it is up to organisations like the media to hold the people in charge of the health service to account.

In that way, parents across Northern Ireland can be sure that, when they leave their children in hospital, they will receive the best care possible. Of course, it will be of little comfort to the grieving families. But it is the very least we can do to help ease their pain.

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