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97-576: The Platt Report , formerly known as the Welfare of Sick Children in Hospital (Ministry of Health, 1959) , was a report that was the result of research into the welfare of children who were undergoing medical treatment within the UK and to make suggestions that could be passed on to the hospital authorities that would improve their welfare during hospital visits. The report was named after Sir Harry Platt , who

194-467: A NAWCH survey of 67 hospitals showed that only 57% allowed unrestricted visiting. The same picture emerged regarding the results of survey of 636 hospitals in the United States, reporting only 62% allowed unrestricted visiting. With a desire to seek a more benevolent approach to the care of children in hospital, changes occurred that led to a broader trend within the development work. In Toronto ,

291-445: A child under 5 years was invited to come into residence in the hospital, without discriminating between good mothers and over-anxious mothers. Bowlby and Robertson created a film, which was more about the study of human relationship, and showed how children responded differently to treatment when mother was present and how the staff of one hospital had created a way of admitting the mother with the child without making structural changes to

388-623: A clinical lecturer in orthopaedic surgery at the University of Manchester when he was appointed professor. Platt was a specialist in the congenital dislocation of the hip and peripheral nerve injuries. During World War II , he was an advisor to the Emergency Medical Service . Platt was President of the Société Internationale de Chirurgie Orthopédique from 1949 to 1954. Platt was elected to

485-565: A good fit with the needs of the medical community. Indeed, by the 1930s many voluntary hospitals had already become fee-charging institutions. During World War II , the Emergency Medical Service that was established to care for civilian casualties during war, acted as a blueprint for what a future integrated medical care service, in the UK, could look like. With the publication of the Beveridge Report in November 1942, that posited

582-472: A hospital, they separated from the mothers and families and only visited, on a very strict visit schedule. By the end of the 20th century, children's hospitals had become depersonalised scientific institutions dominations by both male and female professionals. With the rise of behaviourism from the 1900s to the 1950s, children were rarely seen as individuals, and they became more of a collective problem to be solved. Behaviourism had many advocates, and amongst

679-518: A philosophy of family centred care was later adopted in Canada. A good example of this was developed at McMaster University in 1969, in building a new Health Science Centre. Nursing staff arranged visits to specialised facilities for the architects of the centre, enabling the nursing unit and nursery design to be changed to incorporate the Rooming-in concept to be adopted at the centre. In the 1960s,

776-498: A resident parent did sleep more than the others, children who in the scheme cried less in total than the others outside it, and that nursing staff spent less time with the care by the parent group than with the others despite the demands of teaching and support. It also found that children who were accompanied by their mother had significantly lower rates of post-operative complications, including infection and emotional distress, than those who were unaccompanied. However, nurses involved in

873-489: A theory of phases of response of the under 3's to a stay in hospital without the mother: Protest, Despair and Denial/Detachment. In the protest phase, the child is visibly distressed, cries and calls for their mother. In the despair phase, the child gives up hope of his mother returning and becomes withdrawn and quiet, and may appear to be 'settling'. In the denial/detachment phase, the child shows more interest in his surroundings and interacts with others - but seems hardly to know

970-526: The British Medical Journal which criticised government plans to evacuate a million children from towns and cities to the safety of the countryside. Controversially, Bowlby and his co-signatories pointed out in a letter that the psychological danger of removing children under the age of five years, from their mothers far outweighed the dangers of leaving them in cities. Despite L.A. Perry 's 1947 Lancet article, that vigorously protested

1067-485: The British Paediatric Association but these views were rejected. Instead Robertson decided to take a different tack, by making a short, silent, black and white, documentary film in November 1952, called A Two-Year-Old Goes to Hospital Using a hand-held camera, Robertson working with his wife Joyce Robertson , a researcher, selected a little girl, called Laura, aged 2 years and 5 months, who

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1164-580: The Department of Health . Previously the commission also produced performance assessments for councils, fire and rescue services, and housing organisations. In July 2009, it launched the Comprehensive Area Assessment, which assessed the effectiveness of local public services. Between 1983 and 1998 the commission was self-funding, operating purely on income from audit fees. In 1998 the central government began providing grants to

1261-547: The Hospital for Sick Children was at the forefront of this approach, when it introduced a blueprint to enable parents to care for their children. The kind of approach developed in Toronto was called Rooming-in, and described a hospital unit at St. Michael's Hospital in Toronto, where both the mother and father look after their newborn baby in a room where both mother and baby are cared for together. The Rooming-in concept as

1358-642: The Institute of Chartered Accountants in England and Wales , only 101 people in the entire country were qualified to audit local government accounts. Functions of the Audit Commission included: The Audit Commission worked in partnership with – but operated independently of – a number of government departments including the Department for Communities and Local Government , the Home Office , and

1455-800: The National Health Service in 1990, and fire and rescue services in 2004. In 1996 the commission began joint reviews of social services (with the Social Services Inspectorate of the Department of Health), and in 1997, reviews of local education authorities (LEAs) jointly with Ofsted . On 1 April 2005, the commission's remit in Wales was transferred to the Auditor General for Wales . The gerrymandering Homes for votes scandal at Westminster Council

1552-734: The Royal College of Physicians and Surgeons of Glasgow , Royal College of Physicians , Royal College of Nursing , the Tavistock Institute and the National Association for Maternal and Child Welfare . The British Medical Journal confirmed in an article on 18 November 1961, that on the previous 9 November, that in reply to a question, in the House of Commons , the Minister of Health, Enoch Powell , accepted

1649-553: The Secretary of State for Communities and Local Government , Eric Pickles , announced that the commission was to be scrapped, with its functions being transferred to the voluntary, not-for-profit or private sector. The government aimed to save £50m annually, with the commission's function transferred to the Local Government Ombudsman and private accounting firms. Accounting body ACCA expressed doubt that

1746-551: The Tavistock Clinic , James Robertson , the Scottish social worker, and psychoanalyst , started researching the separation of young children by their parents. Bowlby was the scientist who developed classic theories about maternal separation. Robertson focused his research on separation of mother and child due to hospital admission. When Robertson first started to make observations of young children in hospital wards, he

1843-558: The United States . The main recommendations of the report were: During the twenty years after the Platt Report, parents wanting to visit their sick child who were formerly excluded, moved to parents being tolerated by the medical community when they wanted to visit their sick child and this was a break from what could be considered tradition and a move towards a more humanitarian viewpoint. James Robertson continued to research

1940-443: The local government minister , admitted that the local government audit system "has not worked as well as it should for a number of years". Only five out of 467 local authorities had their 2022-23 accounts signed off before the required deadline. The Guardian reported that ten public bodies (including Slough Borough Council , which had issued a Section 114 notice in 2021) had not had an audit in five years and that, according to

2037-453: The otorhinolaryngology wards, with 24% being denied visits on the day of the visit, with many children spending up to 36 hours away from their parents. It was clear that attitudes were changing as a new generation of doctors and nursings arrived, that naturally accepted the findings of the Platt report, but were stymied by outdated processes, infrastructure and traditional attitudes. In 1984,

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2134-468: The "deserving poor" largely reflecting Victorian values. Children could only be admitted, if they were sponsored by a letter of recommendation, from a hospital affiliate. The "undeserving poor" were sent to workhouse infirmaries, whilst middle class children were generally cared for, and indeed operated on, at home. These hospitals set their own rules and had their own way of working, including regulating admissions, that often excluded infants and children under

2231-522: The 1980s onwards, due to a new generation of doctors and nurses who were sympathetic to the recommendations of the report. A follow-up study by NAWCH during 1986 showed great improvement, although a detailed look at changes in the interim year showed a few instances where small children's units had closed and children transferred to adult wards. The second survey was, however, on the whole very encouraging with 85% of parents having open access and another 4% of parents on open access except on operating day. With

2328-535: The 1980s, it was obvious to observers that the situation was changing with respect to the ability of parents to visit their sick children in hospital and care for them. Pressure groups like the National Association for the Welfare of Children in Hospital worked tirelessly to push back the boundaries of care, and influenced the development of advocacy in the wider social contract. In 1982, an NAWCH survey

2425-696: The Care-by-parents model was being developed with the first unit developed and established in Lexington, Kentucky . In these Care-by-parents units, parents would live with their sick child. This model was developed to both safe money and quality of care, under the supervision of a nurse. The Care-by-parents room was designed with en-suite facilities. Coffee and tea making machines were provided with laundry facilities. In these units, parents were taught to care for their child and were particularly beneficial for babies who were being breast fed. For that model,

2522-545: The Central Health Services Council, that was part of the Ministry of Health, to establish a committee to undertake a special study of the arrangements made in hospital for children and the very young and to make recommendations to those hospitals, in the form of a report. The Terms of Reference for the production of the report was: To make a special study of the arrangements made in hospital for

2619-747: The Council of the Royal College of Surgeons in 1940, serving there for eighteen years. He was elected vice-president in 1949–1950 and president 1954–1957. He was the first orthopaedic expert to be president. He campaigned for the creation of the International Federation of Surgical Colleges , which was created in 1958. In 1959, Platt produced the Platt Report on 'The Welfare of Children in Hospital', which encouraged hospitals to permit parents to visit and care for their children in hospital much more than had previously been allowed. This

2716-533: The Ministry of Health and government, they were under no legal obligation to implement the report. In this manner, the NAWCH became a pressure and advocate group, applying pressure both on the government and the nursing profession, which throughout the 1960s and 1970s continued to resist the new recommendations, and advocating for sick children and their families. The NAWCH developed a series of techniques to get hospitals to relax their strict rules. One of these techniques

2813-415: The National Association for the Welfare of Children in Hospital decided to issue a charter to reflect their values and in order to raise the quality of services for children. Jenny Davison of the NAWCH wrote that it was "formulated by procedures which have become a model for later standard setting". The charter was constructed of 10 principles, with e.g. principle 2 stating that "Children in hospital shall have

2910-867: The Nurse in the Modern Community, b) Preparation of the Student Nurse for Registration and of the Pupil Nurse for Enrolment: the Organisation of the School of Nursing, c) Preparation for Entry to Nursing. Committee members included Annie Altschul , Barbara Fawkes , Catherine Hall (nurse) , and Winifred Hector . He died in 1986 at age of 100 . Platt had been much influenced by the work of Robert Jones in Liverpool and by his training in

3007-532: The Royal College of Surgeons. He was appointed a Knight of the Most Venerable Order of the Hospital of St. John of Jerusalem (KStJ) in February 1972. Audit Commission (United Kingdom) On 13 August 2010, it was leaked to the media, ahead of an official announcement, that the commission was to be scrapped. In 2009-10 the commission cost the central government £28 million to run, with

Platt Report 1959 - Misplaced Pages Continue

3104-526: The US. He continued to be inspired by US methods for medical training and organisation. Among those whom he influenced in turn was John Charnley . Platt became a Knight Bachelor in 1948. He was invited to deliver the Bradshaw Lecture to the Royal College of surgeons in 1950, which he made on the subject of bone sarcomas . Platt was made a baronet in 1958, on completing his term as President of

3201-526: The United Kingdom now evidenced the premise that maternal deprivation was damaging to the child and this simple fact further challenged the tenets of Behaviourism. During interwar period, there was a growing realisation, that the ad hoc system of municipal hospitals, many that were former work house infirmaries and voluntary hospitals that provided 25% of care services, no longer provided the level of services that were needed and were no longer considered

3298-535: The age of two on humanitarian and pragmatic grounds. The Scottish paediatrician George Armstrong , who established the first British dispensary , in 1769, was against in-patient care, i.e. hospitals for sick children. Armstrong stated: But a very little reflection will clearly convince any thinking person that such a Scheme as this can never be executed. If you take away a sick child for its Parents or Nurse, you break its heart immediately. Objections to admission were sometimes based on pragmatic reasons, e.g. reducing

3395-400: The arrangements made in hospitals for the welfare of ill children – as distinct from the medical and nursing treatment – and to make suggestions which could be passed on to hospital authorities. The findings of the report by the committee was that hospitals were miserable places for children, and while in hospital, they had to follow strict ward routines, and were not allowed to play. Moreover,

3492-668: The benefits of these units were more apparent in terms of shorter and fewer visits. The study noted that where a care by parent option could be introduced into a paediatric unit, it had a distinct social and psychological advantages for the children in hospital as well as longer term benefits. In a 1968 study by Brain and Maclay's in the University Hospital of Wales in the United Kingdom , 197 children who underwent tonsillectomy and adenoidectomy were split into three control groups. The study found that children without

3589-490: The child's recovery. Sir James Calvert Spence began the practice, then unique in Britain, of admitting mothers to hospital with their sick children, so that they might nurse them and feel responsible for the child's recovery. However, as a visionary, Spence was unique in this position, during that period in the 1920s, when he established his resident mother and baby unit in 1926. By the 1930s there were physicians who recognised

3686-478: The commission due to its new responsibilities under "Best Value" legislation, and for the cost of setting up the Best Value and Housing Inspectorates. In 2009-10 the commission had an operating income of £213.1m. 86% of this came from fees charged to bodies audited; just 13% (£28.0m) came from central government grants. Around 70% of the commission's income in 2009-10 came from the local government sector, with

3783-514: The commission was abolished. Provision to abolish the commission was included in the Local Audit and Accountability Act 2014 , and the commission was formally closed on 31 March 2015. By 2023, it was being reported that many councils were years behind on having their accounts audited and that the closure and privatisation of the Audit Commission was being seen as a failure. In an October 2023 piece for The Municipal Journal , Lee Rowley ,

3880-507: The committee with Dermod MacCarthy to show his film A Two-Year-Old Goes to Hospital , but upon requesting the BBC to show the film nationally, were refused, as the BBC had consulted medical opinion, which agreed that the film would cause anxiety to parents. However, the evidence provided by James and Joyce Robertson was extremely influential to the final recommendations of the report. The final report

3977-423: The debate in a manner that was scrupulously fair. Both parents and health professionals as well as children's organisations including charities gave evidence. The Association of British Paediatric Nurses provided evidence to the contrary, arguing for the status quo, that frequent visitors brought infection into the ward. Both James Robertson and John Bowlby also provided evidence. James Robertson appeared in front of

Platt Report 1959 - Misplaced Pages Continue

4074-554: The effects of hospitalised and institutionalised care in the commission to write a report for the World Health Organization 's on the mental health of homeless children in post-war Europe. In the late 1930s, work by René Spitz , an Austrian-American psychoanalyst , confirmed the findings by Edelston, Bowlby and Perry, specifically deleterious effects of hospitalisation, based on his research with institutionalised children. Empirical research from both America and

4171-558: The face of patient care in the UK. Commenting on the report in the BBC article, Professor Martin Johnson , professor of nursing at the University of Salford , stated of the report that: Pamela's study was done against the background of a lively debate in paediatrics and psychology as to the degree women should spend with children in the outside world and the degree to which they should be allowed to visit children in hospital... Of course we know now that they had almost given up hope that mum

4268-488: The fact that he himself had seen irreversible change as a result of the separation of small children from their mothers. Both the editors of The Lancet and The BMJ discussed the meeting. The BMJ agreed that the 2-year-old girl was unhappy, and that this was in line with the findings of John Bowlby . The Lancet stated that the audience frankly refused to admit that the child was distressed and were reluctant to believe that it might cause long term damage. Robertson's memory of

4365-550: The film findings were applicable to British children, but they did not apply to American children, and were perhaps less cared for and protected in an overindulgent way, and were, therefore, less upset at being separated from their parent. However, Robertson's subsequent research in the United States merely confirmed his findings, and showed that on both sides of the Atlantic, there were those who were in favour of unrestricted visiting, and those who were not. Robertson eventually viewed

4462-424: The film to paediatricians and other healthcare professionals in the United Kingdom , France , Denmark , Netherlands , Norway and Yugoslavia . Robertson noticed that younger professionals were more accepting of the evidence, while senior professionals tended to reject the film. Robertson's successor film was called, Going to Hospital with Mother . Robertson chose Amersham Hospital specifically, as every mother of

4559-563: The film was shown widely, the pace of progress was still glacial. Indeed, The Lancet reported in 1956, that only 10% of hospital now restricted visiting, even though the Minister of Health Robin Turton was repeatedly asking for changes. The glacial process resulted in pressure being brought to bear by both James and Joyce Robertson with other doctors and parents against the medical establishment, and resulted in Robin Turton commissioning

4656-404: The foundation of a Welfare state as well as an integrated medical care service in the form of a National Health Service , that was subsequently established in 1948, it enabled national policy directives to be applied to the whole service. The Platt Report was one of those directives, designed in a manner, to improve the delivery of care. With the introduction of Penicillin into the majority of

4753-853: The introduction of the Leiden charter in 1988 from the European Association for Children in Hospital that became a working framework for national paediatric organisations in Europe and the creation of the Convention on the Rights of the Child formalised the Platt report recommendations at the international level. By 1993, a report by the Audit Commission , called Children First showed further improvements had been made, but highlighted

4850-550: The main objection to visiting. Hunt reported that: The hospitalised child was considered essentially a biological unit, far better off without his parents who, on weekly or bi-weekly visiting hours, were fundamentally toxic in their effect, causing noise, generally disorderly conduct, and rejection by hospital personnel However, the prevailing view was starting to change. John Bowlby , the British psychologist , psychiatrist , and psychoanalyst along with his research assistant at

4947-399: The mawkish, sentimental way you have been handling it. King, who promulgated a specific kind of child rearing, advocated that the child had to be breastfed, based on a strict schedule every 4 fours, not to cuddle them, and not to feed babies or children at night, lest they cried and became spoiled. King had become well known, as a child rearing expert during the interwar period, and his advice

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5044-436: The medical community by the 1940s, the major objection by doctors and nurses, that visits by parents into hospital wards introduced cross infections had been removed. A major review in 1949, over an 11-month period, showed that children admitted to 26 wards in 14 hospitals showed no correlation between visits and cross infection from parents to children. Indeed, by that time, the working practices of doctors and nurses, still posed

5141-529: The meeting, was that "it was if we had dropped a bomb in the hall" and that "the film encountered much resistance and rejection". The speakers also supposedly also said that Robertson "had slandered paediatrics and the film should be withdrawn". Two people who were at the meeting were Donald Winnicott and Sister Ivy Morris from Amersham Hospital and they agreed to a second filming on their ward. Robertson later took film and viewed it to American paediatricians in 1953, but curiously American audiences confirmed that

5238-508: The mid-1950s must be made. From the 1850s to around 1910, most of the cities in the UK had built their own children's hospitals, which included a large number of prestigious hospitals, e.g. Royal Hospital for Sick Children, Glasgow , Great Ormond Street Hospital and the Royal Manchester Children's Hospital . These were independent institutions funded by voluntary donations, and from research, were shown to be designed for

5335-418: The most grievous of the findings, was that parents were under no circumstances, allowed to visit their children outside visiting hours. Membership of the report committee included two surgeons, two physicians, one nurse , and one Registered Sick Children Nurse. From its lifetime of 1956 to 1958, the committee met 20 times to consider both written and oral evidence, taken from a number of organisations including

5432-514: The mother when she visits or care when she leaves. Finally, the child seems not to need any mothering at all. His relationships with others are shallow and untrusting. Bowlby's and Robertson's research was met with hostility by the medical profession. Even their colleagues at the Tavistock Clinic, although accepting, did not feel the same sense of urgency. In 1951, Bowlby and Robertson attempted to get their views across, by presenting to

5529-407: The national level within the United Kingdom from the 1950s onwards, it would have been unlikely these changes would have taken place. Even now, the Platt report is still considered relevant to the forming of policy that aims to improve childcare and associated services. To understand why the Platt Report was produced and put into effect, an examination of the hospitalisation of children, leading up to

5626-463: The need, including Agnes Hunt , who introduced open visiting. During the interwar period, leading up to World War II , research conducted by people like Harry Edelston and John Bowlby further eroded the importance and veracity of behaviourism. Edelston, a Psychiatrist in Leeds, detailed that children were emotionally damaged by their stay in hospital. In 1939, John Bowlby wrote an open letter to

5723-474: The needs of adolescents, indicating that the Platt report recommendations had not been fully implemented. During the first two decades of the 21st century, the re-framing of the idea of family centred care to a child-centred care approach was taking place. This approach was directly influenced by the UN convention, which in turn was driven by the Platt Report recommendations. Without the Platt Report directing policy at

5820-430: The out patient departments as in the wards. Nicholl believed that hospitalisation wasn't necessary, and children were better cared from in their own home, both by their parents and by nurses who made daily visits to the children. Nicholl recognised that "separation from mother is often harmful". However, Nicholl's views were in the exception. For almost 50 years, whether children were in a workhouse infirmary, sanatorium or

5917-545: The outbreak of World War I he was appointed to be surgeon-in-charge of a military orthopaedic centre in Manchester as a captain in the Royal Army Medical Corps . By 1932, his posts included being senior honorary surgeon and surgeon-in-charge of the orthopaedic service, Ancoats Hospital, as consulting orthopaedic surgeon for Lancashire County Council and in 1939 he advanced on his earlier status as

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6014-403: The parents denied open access to children were those whose children were being nursed on adult wards, the survey shows that 48% of children's wards still did not have open access. The children who fared worse were children on ear, nose and throat wards with 24% being denied visits on the day of operation and with many spending up to 36 hours away from their parents. Changes occurred rapidly from

6111-557: The parents were published in 1962 in a book called Hospitals and Children: A Parent's-Eye View . Harry Platt himself wrote the foreword to book. Jane Thomas, a young mother living in Battersea , contacted Robertson to ask what she would do if her own child was hospitalised, and Robertson suggested forming an organisation, which Thomas and a group of women did. The organisation was called the Mother Care for Children in Hospital and

6208-464: The private sector would match the commission's experience and consistency. The Financial Reporting Council suggested to a House of Lords committee that government should not sell the Audit Commission's practice to any of the Big Four auditors , otherwise their dominance of the audit market would be further enhanced. In 2012 a proposed employee-owned firm won only one of ten regional contracts and

6305-448: The problem and to share his findings. He wrote four influential articles for The Observer and The Guardian newspapers to disseminate his ideas, and the issue started to gain traction. In 1961, the BBC agreed to show excerpts of A Two-Year-Old Goes to Hospital and his other films and Robertson gave a live introduction to the films and asked parents to submit their experiences of hospital care to him. The stories Robertson received from

6402-696: The remainder coming from the health sector. Before the Coalition government announced further cuts, the commission had planned to cut spending by £32.1m by March 2013. Thirty percent of the commission's audits were carried out by five private audit firms. The governing board of the Audit Commission was made up of commissioners appointed by the Department of Communities and Local Government . Previous chairmen included Jeremy Newman, former chief executive of BDO International (2008-2011) and Michael O'Higgins (2006-2012), who had for 10 years previously been managing partner of PA Consulting . Marcine Waterman took up

6499-539: The remainder of its income coming from audit fees charged to local public bodies. Local government audit law has its origins in nineteenth century Poor Law and public health legislation. The Audit Commission was established under the Local Government Finance Act 1982 , to appoint auditors to all local authorities in England and Wales and it became operational on 1 April 1983. The National Health Service and Community Care Act 1990 extended

6596-476: The remit of the commission to cover health service bodies. Legislation covering the commission's activities was consolidated into the Audit Commission Act 1998. In 1985-86 the commission led the investigation of the rate-capping rebellion which resulted in 32 Lambeth councillors and 47 Liverpool councillors being surcharged and banned from office. The commission gained responsibility for auditing

6693-458: The report. In 1982, the NAWCH conducted a survey throughout England. The survey found that progress was slowly being made and 49% of wards studied allowed unrestricted access for parents. The survey also looked at where children were being nursed and found that despite the recommendations of the Platt Report being broadly accepted by the government in 1959, 28% of children were still being nursed on adult wards. Whilst it may have been anticipated that

6790-524: The report: The government, with the agreement of the medical profession, accept the main principles of the report. The Platt Report recommended that children should have unfettered access to their parents while ill. The Association for the Wellbeing of Children in Healthcare (NAWCH) had consistently campaigned over many years for the same position, and conducted ongoing monitoring of the effects of

6887-402: The restrictions of parental visits on hospitalized children, Edelston wrote in 1948, that many of this colleagues still refused to believe in hospitalisation trauma Bowlby would later study 44 juvenile thieves and found that a significantly high number had experienced early and traumatic separation from their mother. Bowlby would use the data in 1949 on the delinquent and affectionless children and

6984-426: The right to have their parents with them at all times. (with caveats)". Principle 3 stated that it was the child had the "right to information appropriate to age and understanding". The charter was approved by the Royal College of Nursing (RCN) and the British Paediatric Association (RCPCH). The Sainsbury report, Harry Platt Sir Harry Platt, 1st Baronet , FRCS , KStJ (7 October 1886 – 20 December 1986)

7081-426: The role and expectations of the parents were outlined on admission. In findings by Clearly et al. in a structured observational study, found that children in these units spent less time alone, slept less and cried less. In contrast those children outwith the units, spent time with an ever-changing group of nurses, spent more time alone, spent more time sleeping and cried more. For chronically ill or handicapped children,

7178-417: The strongest proponents of the philosophy were John B. Watson and Truby King . Watson stated the following advice regarding children: Treat them as though they were young adults. Never hug and kiss them, never let them sit on your lap. If you must, kiss them once on the forehead when they say goodnight. Shake hands with them in the morning ... try it out ... In a week's time you will be utterly ashamed of

7275-496: The study still preferred the children to be admitted on their own, but also admitted that mothers were a great help to their children, but felt it was much easier to carry out the medical procedure when the child was left on their own, which enabled the nurse to have a closer contact with the child. Research also showed, that 4% of mothers were difficult to handle by the nursing staff The seminal report by Pamela Hawthorn , published in 1974 and called Nurse, I want my mummy! changed

7372-409: The threat of cross infection from children with diseases such as typhus , diphtheria and measles , that were a major cause of infant mortality. The voluntary nature of hospitals meant that such outbreaks were very costly. Babies and small children required more nursing care. However, by the 1880s more and more hospitals were accepting children. By the 1870s, the prevalent view among doctors and nurses

7469-494: The time." Otorhinolaryngology wards were particularly bad, often getting parents to sign a consent form, that made them agree not to visit the child on the day of operation. Another technique was to recruit sympathetic doctors and nurses who could advocate for change. The NAWCH drew attention to these practices by issuing press releases detailing their findings and providing leaflets to parents when visiting hospitals that allowed unrestricted visits, telling them of this fact. By 1969,

7566-490: The ward. The second film was based on Sally, who is 20 months old, and is lively and funny. When attending hospital for a minor operation, she arrives with her mother. When the surgeon calls, Sally protests, but with her mother there, her protest is brief. The film follows Sally throughout the hospital visit with her mother present throughout. When Sally returns home, she has none of the attendant disturbed behaviour of those who have been in hospital without their mother. Even though

7663-406: The welfare of children – as distinct from their medical and nursing treatment - and to make suggestions which could be passed on to the hospital authorities. The report was commissioned on 12 June 1956. Sir Harry Platt , who was a former president of the Royal College of Surgeons of England was chosen to be Chairman of the committee. The committee met 20 times to take evidence from both sides of

7760-434: Was admitted to hospital, for the removal of tonsils, a common operation in those days. Laura was initially composed, until she realised her mother had actually left her there, and the film shows how she developed acute and continuous distress... Laura pleaded to be taken home, but as her protests and pleadings were useless, they were gradually followed by despair. She became listless, unsmiling and her traumatised emotional state

7857-562: Was an English orthopaedic surgeon , president of the Royal College of Surgeons of England (1954–1957). He was a founder of the British Orthopaedic Association , of which he became president in 1934–1935. He was born in Thornham, Royton, Lancashire , the son of Ernest Platt, a velvet cutter and later chairman of United Velvet Cutters, Ltd. Harry developed a tuberculous knee as a child and his early education

7954-715: Was at home. He entered the Victoria University of Manchester to study medicine and qualified in 1909 from both Victoria and London Universities. After resident and registrar appointments he demonstrated anatomy at Manchester Royal Infirmary . His orthopaedic training was mainly at the Royal National Orthopaedic Hospital in London, and in Boston, USA. On his return to England in 1914, he was appointed surgeon at Ancoats Hospital but on

8051-403: Was carrying out surveys of all hospitals, which found that although the hospital said they allowed unrestricted visiting, the reality would be different. One hospital reported they allowed unrestricted visiting, "but not in the mornings". Another stated, that "It was the aim of the board of Governors to have unrestricted visiting, as long as the parents understand that they can't be in the wards all

8148-457: Was conducted that looked at access on children's wards throughout England by Rosemary Thornes . The report found that 49% of wards studied allowed unrestricted access for parents. The report looked at where children were being nursed and found that despite what the Platt Report recommended, 28% of children were still being nursed on adult wards, and that 48% of children's wards still did not have open access. The children who fared worse were those on

8245-438: Was ever coming back....But children were alone and depressed so Hawthorn said parents should be allowed to visit. Hawthorn investigated nursing care in 11 hospitals, used qualified nurses who asked questions from standardised questionnaires to gather the research, and found that unrestricted nursing times ranged from the full days access to just a few hours a day. In wards that recognised and implemented Platt's recommendations, it

8342-489: Was found that children were less likely to be lonely or miserable. The most important finding from the study and what prevented the widespread uptake of Platt's recommendations was the lack of Registered Sick Children's Nurses (RSCN) on the wards. Hawthorn's report found that only 575 RSCN nurses were being trained annually in the 1960s and 1970s, which was insufficient to ensure that every children's emotional and psychological needs were being addressed properly while in ward. By

8439-405: Was founded in 1961. Thomas sent a letter to The Guardian detailing her experiences, and the responses allowed the organisation to grow and campaign for the full implementation of the report. Soon regional groups appeared all over the UK and these amalgamated in 1963, and became the National Association for the Welfare of Children in Hospital (NAWCH) in 1965. Although the Platt Report was accepted by

8536-463: Was heart-rendingly clear, and on those occasions when her mother did visit during the eight days she was in hospital, Laura would turn away from her. Robertson's film was shown to the Royal Society of Medicine on 28 November 1952, before a large audience of doctors and nurses. Donald Winnicott on seeing the film spoke of "highly successful film" that dealt with a "real problem" and evidenced

8633-425: Was launched as a subsidiary of Mazars . Grant Thornton won the largest share, four contracts, and took on about 350 staff from the commission. KPMG and Ernst & Young won three and two contracts respectively. The Commission estimated that audit fee savings at 'up to 40%' will arise as a result of these arrangements. A small number of staff were retained at the Audit Commission to monitor these contracts until

8730-440: Was sent to Lord Cohen of Birkenhead, Chair of the Central Health Services Council on 28 October 1958. The Platt Report was made up of four sections, dealing with preparation for admission, admission procedure, in-patient care and patient discharge, respectively. The Report had profound and lasting effects on the welfare of children, not only with the United Kingdom, but in other countries like New Zealand , Australia , Canada and

8827-486: Was shocked by the unhappiness he saw among the youngest children, in particular those aged under 3. The competent, efficient doctors and nurses gave good medical care but seemed unaware of the suffering around them. They saw that children initially protested at separation from the parents, but then settled, becoming quiet and compliant. However, Robertson saw this as a danger signal. Based on several years of observations in long and short stay wards, Bowlby and Robertson formed

8924-519: Was that children were better off by being removed to hospital, away from the often poor, unsanitary conditions at home. There were enlightened people like surgeon James Henderson Nicholl of the Glasgow Hospital for Sick Children, who pioneered day surgery procedures such as Hernia and cleft palate and who stated in 1909 that: [I]n children under 2 years of age, there a few operations indeed that cannot be as advantageously carried out in

9021-517: Was the President of the Royal College of Surgeons . Platt produced the report at the behest of the Ministry of Health in the UK government. The recommendations in the Platt Report, provided the means by which a child trauma ward of a hospital should be planned for children. Established on 12 June 1956, the committee that was to produce the report defined their remit as: To make a special study of

9118-553: Was the result of a three-year enquiry by a committee set up to investigate the welfare of children in hospital, as opposed to their medical needs. Before this time parental visiting was commonly limited to just a couple of hours a week. In 1964 and 1965 he produced the 'Platt Report(s) on the Reform of Nursing Education'. He had established a committee in 1961 to consider all aspects of nursing education and to make recommendations. He created groups to look at: a) The Place and Functions of

9215-401: Was uncovered by the Audit Commission's District Auditor, John Magill, who found that between 1987 and 1989, council houses were sold at below market value to families likely to vote Conservative . Mr Magill found the former leader of the council, Dame Shirley Porter and five other council officials 'jointly and severally' liable for repaying £36.1 million to the council. Mr Magill's verdict

9312-563: Was upheld in the House of Lords in 2001. Dame Shirley Porter eventually settled in 2004, paying £12.3 million to Westminster Council. Since 1996 the Audit Commission has run the National Fraud Initiative, a UK-wide anti-fraud programme. Between 1996 and 2013 it traced £1.17 billion in fraud, including £215 million in 2008-9, as more councils provided data and most recently £203m in 2012-13. On 13 August 2010,

9409-485: Was widely accepted by the medical community. By the 1920s, hospitals were grim places for children, and only addressed the physical needs of the child, never noticing the emotional and psychological needs. However, there were dissenting voices, both for those who had started to question the tenets of behaviourism, and those who already recognized the unique link between the child and their mother, who would nurse them in times of ill health and who always felt responsible for

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