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Last Updated: Monday, 27 March 2006, 11:41 GMT 12:41 UK
Early babies dubbed bed blockers
Newborn
Many premature babies have significant disabilities
A row has broken out after experts described the costly treatment of very premature babies as "bed blocking".

A report by the birth specialists' professional body said the care of sicker babies was compromising services for healthier babies and their mothers.

Costs must be considered as experts became able to save more and more earlier babies, the Royal College of Obstetricians and Gynaecologists added.

Premature baby charity Bliss said such babies had as many rights as others.

We might as well have a policy of not treating victims of car crashes which occur at over 50 miles an hour
Rob Williams
Bliss chief executive

A Bliss spokesman said to deny a baby born under 25 weeks the right to at least an examination would be a gross abuse of their human rights.

He added: "Decisions as to what course of treatment is appropriate should be based in the individual circumstances of each baby rather than a blanket policy of not treating patients born at less than a certain gestation.

"There are many circumstances in which it would not be ethical to propose aggressive medical intervention and these become apparent during examination of the baby."

Bliss chief executive Rob Williams said: "We might as well have a policy of not treating victims of car crashes which occur at over 50 miles an hour, or denying medical services to those over a certain age."

'Success'

But a spokeswoman for the royal college said there was a proper professional concern around the high death and disability rate of babies born under 25 weeks.

The RCOG report to the Nuffield Council on Bio-ethics said: "Some weight should be given to economic considerations as there is a real issue in neo-natal units of 'bed blocking'; whereby women have to be transferred in labour to other units, compromising both their and their babies' care.

"One of the problems of the 'success' of neonatal intensive care is that the practitioners are always pushing the boundaries.

"There has been a constant need to expand numbers of cots to cover the increasing tendency to try and rescue baby at lower and lower gestations."

President of the Royal College of Paediatrics Professor Alan Craft said many paediatricians would support moves to bring in a model followed in the Netherlands of no active intervention for these very early babies.

Inquiry

He added: "The vast majority of children born at this gestation who do survive have significant disabilities.

"There is a lifetime cost and that needs to be taken into the equation when society tries to decide whether it wants to intervene."

A spokeswoman for the RCOG said the welfare of all mothers and babies requiring care because of premature birth or delivery is of primary concern.

"We would welcome further discussion with colleagues about the management of all mothers and babies in this difficult situation."

The Nuffield Council is conducting a two-year inquiry into prolonging life in premature babies.

'Inhumane'

Among the questions the consultation is asking is whether the economics of treating and then bringing up a disabled child should be a factor in decisions made by doctors and parents about whether to continue treating very sick babies.

Pressure group Patient Concern said the attitude of the Royal College of Obstetricians and Gynaecologists towards premature babies would horrify potential parents.

The group's co-director Joyce Robins said: "Babies born at 24 weeks have nearly a 40% chance of survival. What is the next step? Withholding treatment from anyone with cancer, heart or respiratory disease who has only a 40% chance of a worthwhile life?

"Once we have doctors marking people for life or death on this inhumane basis, we shall find ourselves in a terrifying society."


SEE ALSO:
Concern at baby care contingency
28 Oct 05 |  Scotland


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