Health: Congenital Heart Disease
Debate between Baroness Chisholm of Owlpen and Baroness Morgan of Huyton
Baroness Chisholm of Owlpen
I understand, but this is a time-limited debate. I have only 12 minutes to speak and if interrupted, I cannot. I am very sorry. I shall continue the quote:
“In … one year, a formal transfer of care was required to 18 different specialties … These specialties included urology, renal medicine, metabolic medicine, general surgery, respiratory medicine, plastics, neurosurgery, neurology and haematology”
Having those all in one location obviously makes a huge difference. This way of working brings paediatric cardiac care into line with expectations in other specialist children’s services. Collocation of specialist children’s services is the accepted international norm, and this is why the standard requires collocation on the same hospital site.
Baroness Morgan of Huyton
The way the Minister is replying suggests that the decision has already been taken. I thought we were having a consultation and there is then going to be a decision.
Baroness Chisholm of Owlpen
The decision has not been taken. I am explaining why collocation is the accepted international norm. I am not saying the decision has been made. I am just putting forward the reasons why we hope we will be able to do this, but the consultation will come out later in the year, we hope.
The noble Baroness, Lady Masham, asked about continuity of care. Collocation would encourage that. It not just about the ability to get to the bedside within 30 minutes of the call. The aim is to have immediate access to a full range of specialists, operating theatres and intensive care for the sickest children. Experience shows that once families have used a collocated service, they do not go back.
No final decisions have been made yet, and we need to wait to see what comes out of the next stage of the process. Responses to the consultation will now be carefully considered, and NHS England expects its board to reach a decision by the end of this calendar year. Any change to CHD services would be implemented at the correct pace. I want to be quite clear: this is not a cost-cutting exercise and funding is not the issue. The recent protest march, which featured the noble Baroness, shows how passionately people feel about these issues and their strong desire to defend their local services. I would gently suggest that in celebrating and cherishing the incredible achievements of our current services, we do not lose sight of the obligation we owe to future patients and their families.
This is about ensuring that all patients receive the best care from providers that meet agreed national standards, now in and the future, regardless of where those patients live. I hope that providers and other stakeholders will support these aims and work with NHS England going forward to ensure that sound decisions for the future are taken and, once taken, are implemented effectively and efficiently.
I will just respond to a few issues that were raised during the various speeches. My noble friend Lady Pidding talked about the effect on respiratory services. NHS England’s impact assessments acknowledged that there would be an impact on paediatric respiratory services at the Royal Brompton. A panel that includes respiratory clinicians from outside of London and representatives from other patient and public groups has been set up to assess the potential impact on these services. The panel’s findings will be taken into account by the NHS England board before it takes any decisions concerning these proposals.
The noble Baronesses, Lady Watkins and Lady Finlay, both mentioned the impact on patients and beds. We acknowledge this concern. One of the main reasons for carrying out the consultation is to better understand the impact the proposals might have on the paediatric patients from the Royal Brompton who will go the Great Ormond Street Hospital or the Evelina. The hospitals that will be taking on additional patients have confirmed that they will be able to manage the increase in activity.
The noble Baronesses, Lady Masham and Lady Watkins, mentioned Brexit and immigration. The Government continue to want the brightest and best from the EU and around the world to work on research in the NHS. Government and charities invest £4 billion a year to support world-class research in the UK and will invest more in the coming years.
The noble Baroness, Lady Morgan, talked about the publication of consultation responses. NHS England will publish the independent report on the consultation responses and the relevant NHS England board papers.
Finally, let us remember that the strength of the NHS does not reside within any individual institution. NHS England has a responsibility to ensure that these services deliver the very highest standard of care, regardless of where patients live or which hospital provides that care. We must strive for an objective focus on the actual needs of sick children and their families in this debate. I thank all your Lordships for attending this debate. I realise that people have very strong feelings about what is going to happen to their hospital.