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Case for review of NHS strengthens

THE problem of "boarding" (hospital patients being treated on the wrong ward) is well-known and the consequences are serious.

Patients are more likely to die if they are nursed in departments not specialising in their condition. They also take longer to recover.

The dangers, confirmed in a Scottish Government report, are hardly surprising as the most appropriate care is less quickly to hand. The image of doctors setting out on "safari rounds" to find their patients sums it up all too graphically.

To date we have only heard of boarding on adult wards. But new figures obtained by The Herald and revealed today show the practice is widespread at two of Scotland's biggest children's hospitals, the Sick Kids in Edinburgh and Yorkhill in Glasgow.

It would be unwise to jump to sweeping conclusions about the consequences for younger patients without fuller research. But the news is worrying and the concerns of doctors and nurses should not go unheeded. Moving children with complex needs, who must return to hospital regularly, from ward to ward must be unsettling at the very least. The impact could be much more serious.

The figures, showing nearly 1800 instances of boarding across the two hopsitals over a 12-month period, also raise questions about the new Royal Hospital for Sick Children now taking shape on the site of the Southern General in Glasgow. It is essential it has the capacity and flexibility to cope. The number of beds at Yorkhill, which is to be replaced by the new unit, has fallen from 270 in 2006 to 229 today. NHS planning must take account of birthrate projections but it must also consider the powerful achievements of modern paediatric medicine: children are surviving acute problems that would once have killed them. They are also living longer with complex medical needs. In short, the new children's hospital (a welcome addition to health service provision in the west of Scotland) must be future-proof.

Today's revelations also appear to confirm wider problems of capacity in the health service. The Herald's NHS: Time for Action campaign has highlighted numerous examples, amounting to a picture of a service struggling under the strain of rising demand, as the population ages and the effectiveness of care improves, and budgets that, though protected in cash terms, are struggling to keep pace with the added pressures and rising costs.

Only last week, figures showed dramatic falls in the number of consultants, doctors, nurses and therapists on duty at weekends, compared with an average weekday. Inevitably the figures sparked fresh calls to speed up efforts to create a genuinely seven-day NHS. But, given the pressures on the health service, they also prompted the simple question: How?

Our revelation about boarding in children's hospitals raises yet more questions about the state of our NHS. The case for a comprehensive review of capacity, backed by nurses' leaders but so far rejected by the Scottish Government, grows by the day.

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