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 the report.
[7] With the introduction of the Leiden charter in 1988 from the European Association for Children in Hospital[8] 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.
These were independent institutions funded by voluntary donations, and from research, were shown to be designed for the "deserving poor" largely reflecting Victorian values.
[11] These hospitals set their own rules and had their own way of working, including regulating admissions, that often excluded infants and children under the age of two on humanitarian and pragmatic grounds.
[12] Objections to admission were sometimes based on pragmatic reasons, e.g. reducing the threat of cross infection from children with diseases such as typhus, diphtheria and measles, that were a major cause of infant mortality.
Sir James Calvert Spence began the practice, then unique in Britain, of admitting mothers to hospital with their sick children,[16] so that they might nurse them and feel responsible for the child's recovery.
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.
[17] In 1939, John Bowlby wrote an open letter to the British Medical Journal which criticised government plans to evacuate a million children from towns and cities to the safety of the countryside.
[18][19] Despite L.A. Perry's 1947 Lancet article, that vigorously protested the restrictions of parental visits on hospitalized children, Edelston wrote in 1948, that many of this colleagues still refused to believe in hospitalisation trauma[17] Bowlby would later study 44 juvenile thieves and found that a significantly high number had experienced early and traumatic separation from their mother.
[17] 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.
[20] Empirical research from both America and 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.
[22] 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[23] However, the prevailing view was starting to change.
She became listless, unsmiling and her traumatised emotional state 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.
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 eventually viewed the film to paediatricians and other healthcare professionals in the United Kingdom, France, Denmark, Netherlands, Norway and Yugoslavia.
[3] 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,[33] and resulted in Robin Turton commissioning 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 Association of British Paediatric Nurses provided evidence to the contrary, arguing for the status quo, that frequent visitors brought infection into the ward.
[43] 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.
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.
[50] 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.
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.
[52] 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.
[3] 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.
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.
[58] The 1988 study by Rosemary Thornes, for the NAWCH, supported by the RCN and the RCPCH recommended that all parents under the age of five years should be offered overnight accommodation.
The Keane report, 1986, found that a number of resident parents in hospital perceived their children as temperamentally vulnerable, and needed special reassurance and explanation.
[59] The Sainsbury report, 1986, found that nurses believed that their work role was enhanced, and that most parents coped with caring duties, and were grateful for being considered important in the process of healing.
A Canadian report of 1983, by Evans and Robinson focused on the economic aspects of care-by-parent units by a parent's stay on the ward can reduce costs by resuming nursing tasks, limiting unnecessary procedures, and encouraging early discharge [61] An American report by Stull and Deatrick in 1986,[62] tried to find a methodology for measuring the effectiveness of parental participation in the care of the hospitalized child.
Although research was being conducted in the 1980s to explore the different benefits of parents caring for their children both within hospital, within the community and at home, and were wholly accepting of the Platt report, the British government had a restored focus on the needs of both young and adolescent children, due to a number of sentinel events,[3] that occurred during the late 1980s and early 1990s with the Platt Report being referred to during proceedings.
[70] Recent research has shown that children are capable of learning skills as healthcare members, the ability to effectively communicate with both health professionals and parents, defining goals, and using decisions to get the best possible outcome.