Children in Hospital
By ISABEL QUIGLY
rTHERE is even a Giles cartoon about it, fOr I children in hospital are in the news. And at long last, after years of visits for an hour or half an hour a day, or even a week, or even none at all, and certainly none at all on operation days and the day after, it is being realised that a small child in pain, to whom all kinds of terrify- ing and incomprehensible things are being done, is the last sort of child to be whisked away from everything and everyone he knows and trusts; and that the convenient old idea that a quiet child in hospital is a 'settled' happy child, best not disturbed by visits from the family, is non- sense.
It is not just parents either (who mostly knew it all along, by nature and love and plain horse- sense, and above all by the way the child was afterwards). but those in charge of the arrange- ments for sick children, doctors, nurses and ' administrators who are seeing this. More and more hospitals are coming round to the practices recommended in the Platt Report of 1959: 'free visiting' (that is, visits whenever the parents like to come), mothers staying in hospital with their (generally small) children, when they can and want lo and (the main trouble now) when there's room for them, and a generally freer and friendlier atmosphere all round.
The last four years have seen an almost startling change in official attitudes. And not just official ones: parents, who for so long accepted the rules and the almost religiously held notion that the doctor knew best (even spiritually, as it were), have now got together in a flourishing movement called MCCH (Mother Care for Children in Hospital), which has branches all over the country to see what things ye like locally: not an aggressive body, just a friendly (but firm) pressure group. Its first national con- ference has just taken place, on May 22.
Three and a half years ago, when my son (aged three) had his first operation, his arms were strapped to the sides of his cot, so that he wouldn't pull MT the dressings, just because no one (naturally enough) had time to make sure he
didn't; and yet there was a 'mother's bed' free, and 1 had asked for it and been told I couldn't have it, because it wasn't 'necessary' for me to be there.
Today I think few hospitals, whether they had a free bed for her or not, would stop a mother sitting by the child for as long as she liked, and doing the job of those fearful straps with more love and cunning. Two operations and a year later I got into the same hospital with him, after much string-pulling, anxiety and fuss: looked at askance (since he wasn't dying, so I wasn't 'neces- sary'), but at least there, and with no more strapping. And last month, after a year's wait (a year of incessant minor illnesses) to get into a hospital that actually approves of mothers around, we went in again for what seemed, from the child's point of view, about as good a stay as you could get, during which I was able to be with him every minute.
I have been personal about this because I think my experience has been pretty typical of the past four years, years of thaw and growing humanity and good sense; and because it has shown me that, however much children's treat- ment in hospital has been liberalised, the fact remains that it is still remarkably difficult to get into hospital (except privately) with your child. In an emergency you have to take what you can get, and it is unlikely that will include a mother's bed at short notice. In the case of an operation planned well ahead, or a series of operations (as in our case), you may be tied to a particular course of treatment, a particular surgeon and so a particular hospital, and feel reluctant or unable to change in the middle. Only in the case of something- not too urgent or complicated, that doesn't demand a particular time or a particular surgeon, can you really choose your hospital and then sit down and wait for it.
The Nuffield Foundation's Division of Archi- tectural Studies has now brought out a report called Children in Hospital,* which suggests that in general hospitals each ward of twenty children should have eight of the beds in double rooms where mothers can stay with their children. It then gives a list (two years old, admittedly: a curious time-lag in the case of something as fast-moving as this) of seventy-one hospitals that do in fact take mothers: most of them, with anything up to 700 children, take one, two or three mothers. Together they take just over 6,500 children and just under 300 mothers: not eight in twenty or 40 per cent, the Nuffield Foundation's ideal, but three in sixty- five, or less than 5 per cent. And this is the cream of the hospitals, from the 'mothers-in' point of view. The general run of them still have no facilities at all.
So it will be a long time before mothers can choose whether to go in with their children or not. But meanwhile the general liberalising of children's hospital treatment is perhaps more important than this single problem, and it can go ahead without altering a single brick. Parents can be allowed to see their children into bed when they arrive, maybe to stay for the first meal, for a good slice of the afternoon or even- ing; to be there on the operating day, reassur- ingly, both before and after the operation; to be there, quite simply, as long as they can be and want to be and as long as the child seems to need them. All this the Platt Report recom-
* CHILDREN IN HOSPITAL. Studies in Planning, a report of studies made by the Division of Architec- tural Studies of the Nuffield Foundation, (0.11.P., 40s.) t WHAT HAPPENS IN HOSPITAL. By Claire Rayner, SRN. (Hart-Davis, 12s. 6d.)
mended four years ago, and there is nothing revolutionary about it, The Nuffield Report is much more than an architectural plan for hospitals: it is a history of the way we have dealt with a certain kind of deprived child in the past, and a plan to lessen its deprivation in the future.
And for the great majority of children who have to go in on their own, a book like Claire Rayner's What Happens in Hospitalt can be useful, for it goes on the excellent principle that things you know about are less scaring than things you don't. It is pleasantly, reassuringly written, with drawings to illustrate possible causes of alarm, like syringes and bedpans, but seems a little long for any child who isn't already hospital-minded.
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