Surgery is an eerie subject no matter the circumstances, but when a child needs an operation a whole new sense of apprehension arises. However, in the UK, the current state of child surgery has a major backlog with some children still being on the waiting list since 2020.
According to recent NHS data, the waiting list for children’s treatment, including surgeries, reached 360,000 in May. The Royal College of Paediatrics and Child Health (RCPCH) issued a warning that the list is likely to get worse due to intensifying summertime pressures.
The waiting list in England and Wales grew by more than 100,000 between April 2021 and April 2022 even after increasing by 50,000 in the previous six months.
Speaking in The Independent, Dr. Camilla Kingdon, the president of RCPCH, claimed that despite suffering losses due to the epidemic and a “extremely busy summer,” children’s services had not been given sufficient priority: “I don’t think it’s a surprise at all, that the waiting lists are rising. I think the truth is that the rate of rise of the waiting list for children is more than double the rate of rise for adults.”
Dr Kingdon added: “We’re so busy at the moment with viral infections and just generally super busy, it means our capacity to look after these children post-operatively, particularly for the complex child, is very limited and so, you know, surgery will just be cancelled if you can’t guarantee a paediatric intensive care bed postoperatively the surgery just doesn’t go ahead.”
“There is more than one reason; COVID-19 setting us back, not enough surgeons in the departments they are needed, but some of the other reasons are a lot more controllable,” a leading pediatric surgeon from Guy’s Hospital in London told Artefact.
“A lot of children have been waiting for over a year and some operations have even been cancelled due to silly things such as having to move the venue, and the surgeons will be told the same time as the patient that the procedure will no longer be proceeding.”
When asked what the difference is compared to adult surgery waiting times the surgeon told us: “It is laughable, the time difference, for every child waiting to be seen by a consultant, an adult can be referred, operated on, and sent into recovery all during a child’s waiting time,” they said.
“I wish I could do more to help get more children operated on, but there is nothing I can really do. I do the surgeries however I don’t choose who goes first or where the operations get done.”
So how can this issue be fixed? “Personally I am not sure,” the surgeon admitted. “However, I believe the simplest idea would be to do more operations a month. Also, with the waiting list being as long as it is, hire separate surgeons instead of relying on one surgeon doing child and adult operations”
Currently, according to the NHS, half of all children in need of surgery wait more than 12 weeks for treatment and only 65.4% of young patients were seen within 18 weeks, which is nowhere near the current NHS target of 92%.
While the number of children waiting more than 52 weeks for care was dropping in 2021, it began to rise in March 2022 and increased by 5% in May, but Dr Kingdon warned the official waiting list data, published by NHS England, was a “gross underestimation” of the actual number of children waiting for care overall. She said: “We’re not even collecting the data adequately to be able to truly understand the extent of the problem.”
Wait times for community care services, including those for speech, language, and autism examinations, which are not included in the national data, are of special concern due to the delay. “These are often children who are waiting for autism assessments, where actually that’s going to seriously impact on their ability to function normally for instance, in school.
Yeliz is a mother of two children, has had over two years worth of drama with waiting for surgery on her children. “My son of the age 15 has been having serious knee problems after a very painful sports injury, we was told he would be fine with physiotherapy however he ended up injured again due to a misdiagnosis. After the first year we saw a very helpful surgeon after what felt like months of pointless appointments,” she told Artefact.
“He told my son that he needed surgery as soon as possible due to severity of [the] damage, he has been on the waiting list for four-and-a-half months. Not only is my son still in pain constantly but it has affected his school and social life. Being his age there is many benefits of being at school not just for the education factor, but also with developing social skills which I’m very disheartened that he’s missed out and still missing out of.”
Yeliz’s older son, aged 20, has struggled with knee problems since he was very young, however only once he had turned 18 did the possibility of an operation become more realistic: “My son is now 20 years old, and only two months ago he was referred to a consultant regarding an operation, as we speak he is recovery from having the operation done,” she said.
“One of my sons has been waiting for a disgustingly long two years for surgery, while my adult son was sorted out in two months. The worst part of it all is they are both having the same operation done. It cannot be only me who thinks that it is ridiculously unfair on my youngest child in the sense of how long he has waited. I just hope they both get what they need done, thats the main thing.”
Yeliz was also asked how she believes the NHS could solve the issue of delay and backlog when it comes to child surgery: “After my experience I strongly believe that child surgery should be prioritised above all surgeries that are not life threatening. My eldest son had to wait until he was 20 until being even considered operation worth, now my other child will more than likely get the same treatment from them. It does not seem fair.”
After hearing from both a surgeon and a mother whose children had surgery, who both agree that action needs to be taken but without action being taken it seems as if no solution is in sight, however, Victoria Muthetia is a doctor and a mother who believes she has a plan that could help those in need.
Victoria is a general practitioner as well as a mother of a 12 year-old girl who needs surgery on her foot and has been waiting four months to be operated on. “I know it’s a long wait, and I know there is nobody really at fault, but it is very aggravating to everyone who has to keep waiting to be seen. My little girl is having problems with her foot but she is soldering on although she shouldn’t have to.”
Victoria believes that having more surgeons employed no matter the situation, is the answer: “It makes sense, does it not? The more surgeons performing surgery the more children that get treated. It may not be the case of just hiring more people, but if adult surgeons can become qualified pediatricians then we will have an equal amount of adult and child surgeons. To me, this sounds like the most logistical idea.”
However she is the first to see the flaws in her plan: “I do see how employing loads more people can be an issue, over employment and being overstaffed can be a bigger problem than it seems. If there are too many surgeons, there will not be enough space to perform all these surgeries. But I truly believe that having more people who can do the job would lead to the job being done more frequently.”
Given the distress that some parents are experiencing, it is evident that a solution must be found soon for this major backlog of operations, all of the people spoken to for this article have expressed strong feelings that more can be done.
With the suffering these children have already been through, it is hoped that they get the surgery they need as soon as possible.
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