The lack of staffing guidelines resulted in overworked specialist nursing workers. Other major findings of the NAO audit include lack of cots to respond to emergencies and shortage of specialized 24-hour ambulances to transport babies and mothers to other hospitals.
In 2003, the British Association for Perinatal Medicine recommended minimum staffing ratios of one nurse for every two babies for high dependency care and one to one for intensive care. But the Health Department did not made it mandatory for neonatal units to implement the ratio.
Only half of the 180 neonatal units complied with the 1:2 ratio, while only 24 percent met the 1:1 intensive care ratio.
While the 2003 reform led to lesser need for underweight newborns to travel longer to seek better care, the improvement fell short of expectations.
Every year 10 percent of infants born in the U.K., or 60,000 babies, require specialist care. In 1975, half of such babies died or were stillborn. By 1995, the ratio fell to just one-sixth. An extra 200 to 300 low weight or premature babies could have survived if the health reforms were properly implemented, the NAO said.
Because of these administrative lapses, in Manchester, a woman about to go into labor has only a 10 percent chance of seeing her OB. Reforms had already been initiated, but it will only be felt by 2010.
