Is the crew fit to fly? II: Specific medical considerations.

children's beds is 1 to 3 4, but this figure hides great extremes. For instance, 303 wards say that they have a parent's bed for every child's bed or that they would never turn a parent away, whereas 97 wards, including 27 paediatric general or children's surgical wards, can offer no accommodation whatsoever, on or off the ward, except in a case of emergency. Hospitals were flexible about the location of the accommodation. A total of 363 (46"),) of the 790 wards contrive to have all their parents' beds on the unit, either in parent/baby cubicles or beside the child in the open ward; 126 (16O0) can provide accommodation only off the ward; and the remainder manage a mixture of the two. Discussion These findings indicate that we have reached a halfway stage in the implementation of the Platt recommendations. Parents are still looked on as visitors in half the wards, which limit their presence by blanket rules. These wards need to think through the implications of this policy; if it is desirable for a parent not to be present at any time or on operating day it should be discussed individually with the particular child's welfare in mind. The analysis of the data for ear, nose, and throat wards confirms the picture we have built-namely, that parents have more problems in these wards than in any other. These wards have, however, improved more rapidly than other wards over the past seven years-for instance, the proportion of wards with unrestricted access has risen from 8'' to 320o. The provision of overnight accommodation for parents is still far from satisfactory. In wards where parents are encouraged to stay and help with the care of their children more than half choose to do so. Elsewhere, wards provide no accommodation at all or the ward sisters claim that parents' beds lie empty; in these cases, we feel that there may be a negative attitude that discourages parents from asking to stay. The wards that welcome parents display enormous ingenuity in finding and locating beds, even though the ward might be old and crowded. At least half of the wards that nurse children are not yet part of comprehensive children's units. There has been a welcome trend to admit children to the district general hospital rather than to the small local hospital, especially for surgery. Nevertheless , few specialist surgical wards are being incorporated …