Deficiencies Seen In N.Z. Child Health Services

Press, Volume CVIII, Issue 31768, 27 August 1968, Page 6

Deficiencies Seen In N.Z. Child Health Services

Medical services to children in New Zealand are lagging far behind the rapid advances of others, while large sums are frequently spent in less productive but more spectacular fields, according to the children’s physician at the Princess Mary Hospital for Children at Auckland (Dr R. H. Caughey).

“Some of the present inadequacies of the medical care of children arise from a failure to understand what pediatrics is, and what it could be doing,” he says in an article in the latest issue of the “New Zealand Medical Journal.”

“The acceptance of the importance of a first-class children's hospital on a national basis would do much to maintain present standards and enhance them considerably.” Dr Caughey says the Princess Mary Hospital in Auckland is the only children’s hospital in New Zealand, children in other centres throughout the country being cared for either in wards within a

general hospital, or in adult wards.

However, the Princess Mary Hospital still falls short of the optimum standards for the care of children in hospital, he adds. New Zealand children are 33.1 per cent of the population, a figure which shows a 16.9 per cent increase over the previous five years. "Although New Zealand has for many years complacently claimed to have one of the lowest infant mortality rates in the world, the oft-quoted figures do not include Maoris, among whom the infant mortality and the deaths under 15 years of age are almost double those of the European,” Dr Caughey says. Mortality statistics, he adds, bear little relationship to the hospital resources and professional skill required to keep a seriously ill child out of the mortality tables. They fail to indicate that almost 60,000 children are discharged from or die in public hospitals only each year; nor do they give any idea of the high frequency of disease, both congenital and acquired, of large number of children. Urging more specialisation in child health services, Dr Caughey says that this will unify pediatrics, and close liaison with the adult counterpart will benefit both age groups.

For this reason, a children’s hospital should develop within the complex of a genera) hospital, while maintaining its own identity and independence, he adds. Dr Caughey discusses the teaching role of a children s hospital in both preventive and curative pediatrics at all levels.

In programmes of teaching for various groups, such as doctors, nurses, therapists, social and health workers, parents and children, as well as the public, he says there is still inadequate time devoted to the problems of children. This applies not only to undergraduates, but to the continuing education of family doctors, one half to threequarters of whose practices probably comprise the care of children.

Another function he suggests is the provision of a community centre for the health of the child population from which all groups and agencies embracing the care of children can work and coordinate their activities. “More emphasis must be given to a closer analysis of the origins of a child’s illness which should be seen, not as an isolated episode, but as a reaction to his environment,” Dr Caughey says. He also says an important function of a children’s hospital is to promote research. Disease in children must be studied intensely in the home, at the bedside and in the

laboratory, and there are many problems unique to this country which require much investigation.