Pediatric cardiology care and training - can elements of the English system be adapted?

Abstract

Introduction: There is a continuing need to increase the number of pediatric cardiologists in the national health system, while the number of pediatric cardiologists per population in England, which has a similar training system, is lower. Aim: Investigating the adaptation of some elementaries of the English-style multi-level consultant system in pediatric cardiology in Hungary. Data and methods: We compared pediatric cardiology care in the two countries based on a survey of paediatric cardiologists in the Hungary, National Health Service guidelines and published data in the literature. Results: The number of consultant pediatric cardiologists per total population in England is significantly lower than the number of consultants working in the state system in Hungary (5.2 versus 2.0  paediatric cardiologists/1 million inhabitants ). A large proportion of pediatric cardiology tasks (echocardiography, screening for CHD, chest pain and hypertension) are performed by pediatricians with expertise in cardiology (PEC) or a special trained neonatologists in UK, whereas in Hungary it is carried out by pediatric cardiologists with regional competence. Although threre is no single, standard training programme for NPE (neonatologist performed echocardiography), it is commonly used in NICs in UK. In Hungary, there is a more centralised regional distribution. Discussion: The possible introduction of elements of the English consultation system will lead to an increased emphasis on cardiology training in pediatric training. The emergence of PEC consultants may reduce the regional disparity in pediatric cardiology care, while NPE may improve early vitium diagnosis.