The neonatal intensive care unit and technology

The application of technology to promote the survival of new-born infants is far from new and purpose made incubators were already in use in Europe at the end of the last century. However the impact of this technology was small and widespread access to intensive care for the great majority of at-risk infants has essentially been a feature of the last 20 years in the UK. This followed the development of successful methods for providing respiratory support for these babies. As well as being equipment intensive, neonatal intensive care is also staff intensive. There is little evidence in this area of medicine that technology can replace staff. One of the neglected areas where technology needs to develop now, is at the interface between equipment and staff. Equipment manufacturers would do well to emulate Bill Gates at Microsoft and give the human interface a much higher priority. Providing intensive care to newborn infants is not cheap. Equipment costs for one intensive care cot approach £100,000. A medium sized neonatal unit may have medical equipment costing £31.3 million with an estimated life of between 5 and 12 years. On this basis at least £140,000 would need to be reinvested in medical equipment annually. Although this represents only 5-7% of the total cost of running a unit, finding the money to keep up with technological advances is always a problem. The average cost to the NHS per case is about £7,000 to £10,000. Only society can decide whether £10,000 for a life of three score years and ten with a 90% chance of being as healthy as any other child, is value for money