Peri-operative deaths of children.

A recent report of the National Confidential Enquiry into Peri-operative Deaths in children under the age of ten, looked to the problems of surgery and anaesthesia. The enquiry revealed that there must be changes in surgical practice since children need special skills and facilities, and to ensure that surgeons and anaesthetists do not undertake occasional paediatric experience. They advise that no trainee should undertake any anaesthetic or surgical operation on a child of any age without the express permission of his or her consultant. Some disagree, saying that the overall standard of surgical and anaesthetic care of children is excellent, nevertheless, they do feel there is some room for improvement. The main deficiencies were failure to supervise junior staff, consultants not seeing patients before operations and general surgeons performing operations that should have been done by specialists. Surgeons used to be able to bury their mistakes. This is no longer the case because of the increasing number of reports which closely examine surgical deaths.