Children’s surgeons difficult to recruit due to increasing specialisation, report warns

There is an “inability” to recruit general surgeons for children due to an increase in subspecialisation within the health service, a new report states.
On Tuesday, a new model of care for the sustainable delivery of paediatric general surgery in Ireland was launched by the National Clinical Programme in Surgery and the National Clinical Programme for Paediatrics and Neonatology.
According to the report, challenges remain in the delivery of general paediatric surgery, and in particular emergency general paediatric surgery, in many units outside of Children’s Health Ireland (CHI) in Dublin.
The report said “a lack of investment in paediatric services, infrastructure and facilities” in hospitals where children’s services compete with adult services has resulted in a “lack of priority for the building of robust paediatric skill sets” in some areas.
“As a consequence, many individuals have been placed in uncomfortable and unsustainable positions where public expectations are high and service delivery is compromised, leading to increased referral of children for general paediatric surgery to CHI,” it added.
The model of care sets out recommendations on how service improvements could be achieved with the designation of both regional paediatric surgical facilities and local paediatric surgical facilities.
Under the new model of care, children and families will be able to access appropriate elective and acute surgery close to home, as regional general paediatric surgeons will decide where surgeries will be delivered.
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This means children who require transfer to CHI in Dublin are transferred in a “timely and safe manner” with senior surgeons regionally and in CHI co-ordinating the transfer, while acute surgery for children provided locally occurs in an appropriate environment.
Furthermore, where clinically appropriate, elective procedures will be performed locally.
Ken Mealy, chairman of the working group for the general paediatric surgery model of care and co-lead of the national clinical programme in surgery, said it is a “significant step forward in ensuring that every child in Ireland has access to safe, high-quality surgical care, no matter where they live”.
“This model of care has an emphasis on safety, workforce planning, training and quality assurance of service provision, to ensure that all children who require acute or elective general paediatric surgery are managed in an appropriate environment by staff with the requisite skills,” he added.
Dr Ciara Martin, national clinical adviser and group lead for children and young people at the HSE, said “it is important for those delivering care to children and young people”.
“Even more so it means that patients and their families can be confident of the care they receive wherever and whenever they need it,” she added.