Published: 18/04/2002, Volume II2, No. 5801 Page 9
Parents are facing waits of up to a month for post-mortems to be carried out on their dead children, and cancer diagnostic services may also soon be at risk, experts have warned.
Paediatric pathology services are struggling to cope with the aftermath of the Alder Hey retained organs scandal, which has given them a vastly increased workload at a time when one in five posts for consultant paediatric pathologists are not filled.
This week, Neil McIntosh, professor of child life and health at Edinburgh University and chair of a working group on the future of paediatric pathology, warned that the problems were particularly acute in London, Bristol, Sheffield and Belfast. Some departments are able to carry out post-mortems only when there is a legal requirement, leaving parents and doctors who request a post-mortem facing waits of up to a month.
Professor McIntosh has also warned that cancer diagnosis in children is in danger of suffering unacceptable delays. He told HSJ: 'There is certainly a risk of this.
You cannot foresee when, but if you have a particular problem with post-mortems then cancer biopsies cannot be far behind.'
The Royal College of Paediatrics and Child Health published the working party's report in March.
It found that 20 per cent of consultant paediatric pathologists' posts are vacant.While the shortage was long term, Alder Hey had added significantly to the problem, said Professor McIntosh.
'Alder Hey has created a phenomenal amount of work.
'Every pathology department has had to go back and catalogue every slide, every tissue block and every organ that they had ever taken. They have had to identify whom it came from and notify that family and decide what they want done.'
He knew of one case in London where an obstetrician waited a month for a specialist to carry out a post-mortem. 'That is appalling for the parents, ' he said.
The worst-hit area is Belfast where the Royal Group of Hospitals Dental and Maternity trust suspended routine postmortems in January. They said extra work deriving from Alder Hey and shortages of paediatric pathologists was behind the crisis.
Last week, the trust began to tackle a backlog of 160 paediatric postmortem reports that has left some parents waiting up to a year for a final report on their child's autopsy.
'The backlog built up from early last year when we had to hold our own organ-retention inquiry, ' a trust spokesperson said.
The trust's only full-time paediatric pathology consultant has been on long-term sick leave since January 2002, leaving a part-time colleague in post. The trust, which is the regional centre for paediatric pathology, has not been able to appoint a locum.
Professor McIntosh said services across the UK were struggling.The Department of Health is currently considering the RCPCH report and its 35 recommendations.