Children are not miniature adults

Miss Leela Kapila, report author

But its president has warned that many more paediatric specialists will have to be created to make the change possible.

At the moment, only 2% of consultant surgeons in England and Wales concentrate exclusively on children.

The college argues that doctors who only handle child cases every now and again are not experienced enough to offer the service.

But that is precisely what happens in many hospitals.

Miss Leela Kapila, president of the British Association of Paediatric Surgeons, who co-authored the report, said: "Children are not miniature adults."

"Some of the surgical disorders of the paediatric age group are rarely encountered in adult surgical practice.

"Operative surgery in infants and young children differs in many aspects of technique."

Heart demand

The college has stressed the importance of specialist surgeons in children's heart surgery.

The anatomy of the baby heart is so different from that of the adult - the organ in a baby can be as small as a plum - that specialist techniques are vital.

Although paediatric heart surgery is offered in only a dozen or so hospitals in the UK, the trend now is for surgeons to concentrate exclusively on child work, whereas before, surgeons might be split between this and adult cases.

Mr Barry Jackson, president of the Royal College of Surgeons, said: "I am aware that the recommendations cannot be achieved without consultant expansion - a necessary increase in posts which we have repeatedly drawn to the government's attention."

The report also warns that in-patient paediatric surgery should only be carried out in hospitals equipped to provide comprehensive paediatric facilities, such as intensive care.

All district hospitals, said the report, should provide a dedicated children's ward with trained children's nurses, as well as doctors trained in paediatrics in the hospital at all times, with a consultant paediatrician only a phone call away.

Most child operations in the NHS involve either trauma - repairing damage caused by accidents and other injuries - or minor surgery.