THE consultant gave a deep sigh before attempting to make his point.

"People think we can work miracles but the reality is that we just buy time."

Hundreds of seriously ill patients a year pass through the delicate hands of Dr Stephen Mousdale and his staff who have the awesome job of running the intensive care unit at Blackburn Infirmary.

Sadly, a few people don't make it, but the majority recover thanks to the impressive round-the-clock attention of the team.

Intensive care has shot into the spotlight as one of the emotive issues to capture the minds of the nation. Lack of specialist beds, particularly for children, has led a series of horror stories in the press. But Dr Mousdale, clinical director of intensive care in Blackburn, believes there have been misconceptions and is keen to put the record straight.

A single intensive care bed costs about £250,000 a year to run. At the infirmary there are five beds, each staffed by about six specialist nursing staff. The bed occupancy rate stands at 80 per cent - four patients - which is higher than the standard recommended by the Intensive Care Society.

On the day I met Dr Mousdale there were three patients in the unit.

Among them was pensioner Victor Nicholl, from Darwen, who had been a patient for more than six weeks. He was suffering from a serious neurological disorder which was threatening to lengthen his stay in the unit. The plethora of monitors, wires and equipment surrounding him was what you would expect in such a unit. What stood out was the incredible attention given to him by the staff, who were eager to meet his every need. Victor could not speak properly but, bravely, he was determined to get his message across.

We read his lips, which clearly said: "From the top to the bottom, the treatment is the best."

The debilitating nature of Victor's illness is a common challenge for the medical and nursing staff on the unit. But other regular sights include horrific injuries suffered by the many road accident victims in East Lancashire. The availability of specialist beds across the North West is monitored by the Manchester-based Intensive Care Bed Information Service. The need to transfer patients or even turn them away is becoming a common theme across the country. During the winter, several patients had to be turned away as supply was overtaken by demand.

Dr Mousdale said: "The winter showed how much the service is stretched and that regionally there are not enough beds. We were not as badly-off as some other hospitals but there were occasions when we had to cancel major elective surgery. This is the reality and we may have to do it again." The treatment of critically ill children is where the issue of intensive care has got the nation's blood boiling. Specialist paediatric beds are located in Manchester and Liverpool and the scope of treatment in Blackburn is limited. But staff have received training to cope with youngsters who have "self-limiting" conditions.

Dr Mousdale added: "The children we admit we expect to respond within 24 hours. For example, a child with croup we can treat by inserting a tube to unblock the airways.

"We also treat head injuries where no surgery is needed. If children need more specialist intensive care they are transferred to other centres."

The shortage of beds was highlighted by the high-profile case of Stockport youngster Nicholas Geldard who died after he was shunted around several hospitals.

Dr Mousdale added: "You cannot expect every district to provide specialist paediatric services. That is a fact of life. The realistic way forward is regional specialist centres, but the number of beds does need increasing with a better back-up service.

"Most people are not really aware of the reality. They think we can work miracles. But the reality, and I always say this to relatives, is that we buy time. "We don't cure people and expectations are too high."

As for the stress, you would expect running a unit where death is always hanging around the corner to be one of the most taxing jobs possible. The burn-out rate for intensive care consultants is high and dealing with the daily trauma of critical and serious illnesses could destroy the hardiest of souls. Not Dr Mousdale's.

"I have been here for more than seven years and the work is not that stressful," he said. "Nobody enjoys breaking bad news but we are trained to deal with that.

"What is stressful is when we get involved in management issues - when you have to bid for resources from from a limited pot of cash."

Point taken!

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