Introduction

As in other medical specialties the increasing emphasis on medical audit should be welcomed by the paediatricians. The need to review critically specific aspects of paediatric care is of particular importance. What is implemented by paediatricians may have long-term consequences, potentially into adult life. These consequences may on occasions not be appreciated if they subsequently present only to the adult physician or if adequate follow up is not achieved. It may be difficult to measure every aspect of paediatrics and child health, although a wide spectrum of paediatric care can be covered from child health surveillance, neonatology, paediatric surgery and general paediatrics. It should begin with perinatal care and the developing foetus and thus by definition cross into obstetrics. Although audit in the form of, for example, perinatal meetings have taken place in the past, the recent impetus in initiating more formal audit should remind us that previously some new procedures, drugs and techniques have been accepted with enthusiasm without critical review. Intrapartum foetal monitoring of the full-term baby is so accepted by some that it is thought negligent not to monitor during labour, although a recent study now questions this. Before accepting specific audit procedures as a measure of quality of care then we have to be certain that our guidelines are reliable, as shown in the preceding example.