Congenital Cardiac Services for Children

Baroness Morgan of Cotes Excerpts

Thursday 23rd June 2011 Commons Chamber

[Nicky Morgan (Loughborough) (Con)]

I will try to keep my remarks as brief as possible to allow other hon. Members to have their say. I congratulate my hon. Friend the Member for Pudsey (Stuart Andrew), who secured the debate, and all the other Members who have supported him. I thank the Backbench Business Committee for allowing the subject to be debated in the main Chamber.

I shall speak in favour of the motion. I was first contacted about the issue shortly after the election, and I should like to thank in particular the Russell family in Loughborough for bringing it to my attention. The review is called Safe and Sustainable for a good reason, and I entirely endorse the statement that all hon. Members probably received from the Little Hearts Matter campaign that the review offers a monumental opportunity to ensure that every child with a heart problem has access to the best heart surgery service that this country can offer. I am sure that that is what we all want.

I am, however, concerned by a few comments made by Opposition Members and in a recent article in The Times, which seemed to question why MPs felt the need to defend their local services whenever a reconfiguration is suggested. That is a misunderstanding of the role of 21st century Members of Parliament, however long ago they were elected. We are here to speak up on behalf of our constituents. I am sure that all hon. Members here today and those who cannot be here have been contacted by constituents who are concerned about their access or that of their children and grandchildren—those born and not yet born—to heart surgery should the need arise. It is absolutely our duty to stand up for that and to ask whether the review and the options are right. However, I am very pleased that, as a Member of Parliament, I am not the one making the final decisions.

As I said, I support option A, as do my right hon. Friend the Member for Charnwood (Mr Dorrell) and the hon. Member for Leicester South (Jon Ashworth). I am sure that, although the hon. Member for Leicester West (Liz Kendall) will focus on the national perspective, she will manage to get in a reference to Glenfield hospital somewhere in her concluding remarks. That hospital serves my constituents extremely well and I am in awe and admiration of those who work there—the surgeons, those who run intensive care units, all the nurses, and the many staff who packed the Walkers stadium for two consultation meetings last Thursday. Option A is the highest scoring option and the most cost-effective.

In the time available I want to talk about a topic that the hon. Member for Leicester South touched on—the ECMO services at Glenfield hospital. The hospital treated many of the patients who had swine flu over the winter, and the national leaders of the NHS said that the nation owed Leicester a debt of gratitude for the work that it had done with ECMO. My worry about the review—if option A were successful, I would not have this worry—is that we have a clinically excellent service in ECMO and I do not want to see that jeopardised in any way. As has been said, if the children’s ECMO service is moved, that will inevitably have an impact on the adult ECMO services. We should be very careful in this country about not respecting such clinically excellent services. We should allow them to continue in places where the staff are already well trained and well versed and offer a service of national importance.

My final point, which the Minister addressed—I am grateful to him—is about translation. There are a large number of ethnic minority people in Leicester and in my constituency of Loughborough. My right hon. Friend the Minister generously acknowledged the fact that it would have been helpful if the documents had been translated earlier. The question posed by hon. Members in the debate is whether that impacts on the fairness of the review and the way the process has been carried out. That is clearly for others to judge. It will be interesting to see how many people reply using documents that have been translated.

The timeline in the consultation document shows that the process has been going on for a long time, so it should not have been beyond the wit of man or of the review committee to realise that many of the services are located in areas where there are high ethnic minority populations, and that those documents should have been translated early enough to make sure that members of those populations could play their full part in making their views heard.

[Several hon. Members]

rose—

Oral Answers to Questions

Baroness Morgan of Cotes Excerpts

Tuesday 7th June 2011 Commons Chamber

[Mr Lansley]

Yes, I understand and entirely sympathise with my hon. Friend’s desire to see Croydon Health Services NHS Trust achieve foundation trust status. He will know that the trust was recently the subject of a responsive review visit by the Care Quality Commission, which revealed areas in which further assurance will be needed ahead of its foundation trust application going forward. He will appreciate, as I do, that in the past foundation trust status did not depend sufficiently on the achievement of high-quality services, rather than merely viable services. We intend that in future, foundation trust status will depend on both.

[Nicky Morgan (Loughborough) (Con)]

17. What steps he is taking to improve mental health services.

[The Minister of State, Department of Health (Paul Burstow)]

Mental health is a cross-government priority. Earlier this year we published our mental health outcomes strategy document “No health without mental health”, to drive up standards in services and improve the nation’s mental health. But this cannot just be a problem for the Government, which is why we are working in partnership with the voluntary sector and the wider community.

[Nicky Morgan]

I thank the Minister for his reply, and I am pleased to hear about the emphasis on mental health. During the recess, I met members of the Charnwood health forum, including Leicestershire’s public health lead for mental health matters. He is concerned that there will be no place for him to advise or work with GP commissioning consortia. Can my hon. Friend reassure him that he will be able to advise GPs?

[Paul Burstow]

Yes, I believe that I can. Directors of public health will be the local leaders for public health in their communities. For example, local authorities and GP commissioning consortia will be required to undertake joint strategic needs assessments and produce joint health and well-being strategies for their areas, through health and well-being boards. The directors of public health will be directly engaged in that process and will therefore be able to influence the commissioning not only of health care services but of social care. They will be directly involved in the commissioning of public health locally.

NHS Reorganisation

Baroness Morgan of Cotes Excerpts

Wednesday 16th March 2011 Commons Chamber

[Nicky Morgan (Loughborough) (Con)]

My hon. Friend is making a powerful argument. Does he agree that it is rather tragic—nay, even worse—that we have heard Opposition Members having a go at the motives of both GPs and those who work in hospitals? Opposition Members think that they are driven by money, not by the quality of patient care and outcomes.

[Mark Simmonds]

I thank my hon. Friend for the point that she has forcefully made. A few—not all—on the Opposition Benches believe that GPs are in it for the money. No GP I have ever met, or with whom I have discussed patient care, is interested in money. They are there to improve the lives of the patients for whom they are responsible.

If we are to engage seriously with improving patient care, we must allow any willing provider to provide services, and allow the provider that is best for optimising patient outcomes in a regulated way to drive up standards. As my hon. Friend the Member for York Outer (Julian Sturdy) said, it is perplexing to hear the arguments that Labour Members have been coming out with today, and ever since Christmas. Is it right that substandard and mediocre services should be allowed to continue purely because they are provided by the state, even when the patient can get better care elsewhere at the same cost? That has to be wrong. What is important is the quality of patient care that is free at the point of delivery, not the delivery mechanism.

The shadow Secretary of State’s position is completely untenable. He must be squirming inside, because he is an intelligent man and a reformer. The Labour party introduced foundation trusts, payment by results, patient choice and private sector provision in the delivery of patient care, and it twice introduced GP commissioning. As recently as 2010, the Labour party manifesto stated:

“We will support an active role for the independent sector”—

that is in the Bill;

“Patients requiring elective care will have the right, in law, to choose from any provider”—

that is in the Bill;

“All hospitals will become Foundation Trusts”—

that is in the Bill;

“Foundation Trusts will be given the freedom to expand their…private services—.

that is in the Bill. Labour also claimed that it would

“ensure that family doctors have more power over their budgets.”

That is in the Bill. The Labour party should support the Bill, not castigate it on the basis of false promises.

The Government are absolutely right to push the Bill, which is on exactly the right lines. We need more investment in the NHS, less waste and more powers for doctors and nurses to be involved in commissioning and clinical decisions. We need to focus on results, create accountability and transparency, and facilitate innovation. The Bill preserves the best of the NHS—equality of access—and creates the architecture to drive and deliver excellence for all.

--- Later in debate ---

[Liz Kendall (Leicester West) (Lab)]

This debate is about one of the most important issues facing this House and this country: the future of our NHS. It has been an excellent and at times lively discussion, with important contributions from all parts of the House.

My hon. Friend the Member for Sheffield Central (Paul Blomfield) spoke with great passion about his recent experience of using the NHS and the importance of the NHS for his constituents. My hon. Friends the Members for West Lancashire (Rosie Cooper), for Oldham East and Saddleworth (Debbie Abrahams) and for Kingston upon Hull East (Karl Turner) gave compelling speeches about their concerns over what is really in the Health and Social Care Bill, including the implications of removing certain duties from the Secretary of State and of introducing competition law explicitly in the NHS for the first time. The hon. Members for Southport (John Pugh) and for St Ives (Andrew George) raised important and serious issues with regard to the Bill, including the implications of centralising services such as dentistry, pharmacy and primary care. It is far from clear how a national body will know what primary care services need to be commissioned in my constituency. They also expressed concerns about the dangers in the Bill. My hon. Friend the Member for Warrington North (Helen Jones), whom I am proud to be following, raised the importance of the threats to the “national” in the national health service and concerns about patients with long-term and chronic conditions, of whom we know there are an increasing number in the NHS.

The debate has shown that, as on so many occasions with this Government, it is not their rhetoric but the reality that counts. They promised in their manifesto an end to top-down reorganisations, but instead they are forcing the NHS through the biggest reorganisation of its life. As the right hon. Member for Charnwood (Mr Dorrell) has said many times, although unfortunately not in the House today, they are doing that at a time when the NHS faces its toughest ever period of funding, when jobs are already being cut and when, far from what the Secretary of State told the House earlier, waiting times are starting to rise.

The Government also say that they want clinicians to lead changes in the NHS, but their Health and Social Care Bill fails to guarantee even that GPs will be running consortia, let alone that hospital doctors, nurses or other NHS staff, who are so crucial to improving the quality of care, will be involved. As eight of the country’s leading patient charities said in a letter to The Times last month:

“The reforms will place £80 billion of the NHS budget into the hands of GPs, but plans to make GP consortia accountable to the public are far too weak.”

There is no requirement to have elected representatives on GP consortia, as the coalition agreement promised for primary care trusts. The new health and well-being boards will have no power to require GP consortia to do anything, and local councils’ scrutiny committees will actually lose some of their powers to refer decisions to the independent reconfiguration panel in the case of services not on the safe list of designated services.

At the heart of the Bill are proposals to change the NHS fundamentally that the Secretary of State simply does not want to talk about: his plans to run the NHS along the same lines as the gas and electricity companies.

[Nicky Morgan]

I know that the hon. Lady is a hard-working fellow Leicestershire MP, but I disagree with her. Is not the fundamental principle of the Bill, as we have discussed in the Public Bill Committee, that what constituents want is an NHS free at the point of need and the delivery of services, and funded by taxpayers? Which part of the Bill changes that fundamental principle?

[Liz Kendall]

What patients want is their views and voices to be heard. As the hon. Lady well knows, eight of the country’s leading patient charities, including the Alzheimer’s Society, Asthma UK and Diabetes UK, have said that the patient and public voice is not strong enough under the Bill, and they have demanded changes. I respectfully ask that she look at their comments and act on their views.

The fundamental issues at the heart of the Bill are turning Monitor, which is currently responsible for foundation trusts, into a powerful new economic regulator to promote competition across the NHS, and enshrining UK and EU competition law into primary legislation on the NHS for the first time. That is not my view but the view of David Bennett, the new chairman of Monitor, expressed in his evidence to the Public Bill Committee. The Government are explicitly modelling the NHS on the gas, electricity, railway and telecoms industries. Government Members who are shaking their heads or looking blank should read the explanatory notes to the Bill, which make that absolutely clear.

Health and Social Care Bill

Baroness Morgan of Cotes Excerpts

Monday 31st January 2011 Commons Chamber

[Nicky Morgan (Loughborough) (Con)]

Thank you, Madam Deputy Speaker, for allowing me to contribute to the debate on a Bill that is essential to implementing the coalition Government’s policies. I had intended to say what an excellent debate we have had so far, with some thoughtful contributions from all parts of the House. The hon. Member for Wolverhampton North East (Emma Reynolds) made a thoughtful contribution, but I am afraid the hon. Member for Eltham (Clive Efford) let his side down completely with his offensive remarks about how Government Members view the national health services.

Although she is not in her seat, I congratulate the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) on her contribution to the debate. I did not agree with it, but she gave her speech extremely well.

I welcome the Bill. It is essential that more power is given to front-line doctors, who are best placed to understand patient needs. It is a tragedy that Opposition Members seem to think that GPs are not capable of stepping up to the mark and taking on those responsibilities. From the conversations that I have had with my GPs, I do not understand why the Opposition believe that; they will be proved wrong.

I support the focus on clinical outcomes. I think that GPs are interested in taking on commissioning and the proposed changes. Three consortia in Leicestershire and Rutland have stepped forward so far. My primary care trust is working extremely closely with them, particularly on transferring community services, and I welcome their close working relationships.

The GPs commissioning arrangements will mean that GPs listen to what patients want. GPs will be responsible for community services in Leicestershire and Rutland, including the walk-in centre in the middle of Loughborough and out-of-hours services, which have not been mentioned in the debate. One of the things that patients feel most passionately about is the fact that some GPs, particularly in the part of the country I represent—I cannot speak for everywhere—are not responsible for delivering out-of-hours services. What patients say to me more than anything else is that when they call someone in the middle of the night, they want their GP or someone who has access to their records to answer the telephone, not a call centre.

[Anne Marie Morris]

I absolutely support what my hon. Friend says. I have the very good example in my constituency of Devon Doctors, which is effectively a not-for-profit organisation that provides all the out-of-hours service and gives the people of Devon exactly what she has suggested.

[Nicky Morgan]

I entirely agree with my hon. Friend. It just shows that GPs, if they are given the responsibility, will step up to the plate and deliver what their patients need.

In the limited time available, I wish to focus on what the proposed changes will mean for mental health services. I speak as a member of the all-party group on mental health, and as someone with a family interest in mental health issues. The NHS in England spends more on mental health services than on any other disease category, including cancer and heart disease, and one in four people will experience mental ill health at some point in their lives. The public health strategy has so far not been mentioned in the debate. I entirely welcome the Government’s emphasis on public health and the emphasis on good mental health as well as good physical health. I recently spoke with Charnwood mental health forum, which is based in my constituency, whose members told me that prevention of mental health problems and supporting people who are perhaps heading down the road to depression and more serious conditions is incredibly important.

There are four keys areas that I want to mention in the time available. My first point, which has already been mentioned by the Opposition, is that we must ensure that GPs get proper support to commission effective mental health services and other specialised services. That support can come from the national commissioning board, third sector organisations and patients. That is why I think GPs will step up to the plate, because they will ask their patients and listen to them when designing and commissioning services.

A recent Rethink survey of GPs found that 31% of GPs did not feel equipped to commission mental health services, compared with 75% who felt that they could commission diabetes and asthma services. It also revealed that 42% of the GPs said that they had a lack of knowledge about specialist services for people with mental illness, and 23% said that they had a lack of knowledge about mental illness in the first place. I will cite a recent case study from my Loughborough constituency, in which I was told that one of my constituents was suffering from complex mental health conditions, but his GP appeared to have no knowledge of personality disorders and saw the problem as largely behavioural. The relationship between the constituent and the GP deteriorated and therefore the local Rethink carers group stepped in to help find another GP. With consortia, a GP in a different practice could have that specialisation, and the first GP, realising their limitations, could speak with that other practice and engage with carers groups, such as Charnwood mental health forum or Rethink to ensure that there are special services available for patients.

[Emma Reynolds]

Is the hon. Lady as concerned as I am that a recent survey by Rethink showed that 95% of GPs did not feel that they had sufficient expertise to commission mental health services?

[Nicky Morgan]

I was just talking about that, but the point that has been made is that GPs do not feel that they necessarily have the specialist skills to commission mental health services. That says not that the underlying plan set out in the Bill is wrong, but that GPs recognise their limitations. From the conversations that I have had with GPs, I think that they will know where to go to commission those services and they will get the support from the national commissioning board.

[Hugh Bayley]

Will the hon. Lady give way?

[Nicky Morgan]

I am afraid that I must make some progress.

My second point relates to joined-up care, which carried on from my previous point. People with mental health problems have complex needs and need a clear pathway of care, which might involve the GP, psychiatric care at secondary care level, a social worker and community support services, such as drop-in services. That is essential, and that is what we want to see happen in the NHS.

[Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab)]

I applaud the hon. Lady for making such an excellent case for mental health services, but I would like to pick up on a point about expertise. Under the new arrangements for consortia and the massive expansion in programmes, who will provide the funding? Will it be via town halls or local authorities for care at community centre level?

[Nicky Morgan]

There is already some excellent provision in Leicestershire. I hear the hon. Gentleman’s point, as, I am sure, does the Minister. I am sure that she and her colleagues will look at that in the debate and in future.

I support the “any willing provider” model, which was first introduced by the previous Government. It is often patients with mental health issues who benefit from care at different levels and with different therapies, but it does not all have to be at primary or secondary care level. As I have mentioned, there are organisations, such as Charnwood mental health forum and other drop-in centres, that offer excellent services, and they must be part of GP commissioning and the services that will be provided under the new arrangements set out in the Bill.

Finally, I wish to look at public health involvement through HealthWatch and the local health and wellbeing boards, which is critical. We must ensure that there is broad representation in those organisations. Research from Rethink has shown that stigma and discrimination affect nine out of every 10 people with mental health problems. The boards and those organisations must ensure that the most vulnerable patients are listened to. At a recent meeting of the all-party group, one of the contributors said:

“We all have mental health—it just depends how good ours is.”

Mental health has for too long been a Cinderella service. I am confident that that will not be the case under the new structure because GPs will do their best to understand it or, if they do not, will get in appropriate services. I support the Bill and look forward to hearing how the points I have mentioned will be addressed. I also look forward to the unveiling of the national mental health strategy, which I understand will happen later this week.

Swine Flu

Baroness Morgan of Cotes Excerpts

Monday 10th January 2011 Commons Chamber

[Mr Speaker]

Order. Many right hon. and hon. Members are seeking to catch my eye. If I am to have any realistic chance of accommodating the interest of most Members, short questions and answers alike will be essential.

[Nicky Morgan (Loughborough) (Con)]

The Secretary of State is right that general practitioners are on the front line, and it is to them that patients will turn. Does he have any thoughts on the case of a constituent of mine who contacted me yesterday to say that he has been trying to get a vaccination, but has been unable to do so because he wants to have one after 4 o’clock in the afternoon, when he can get away from work? He does not want to jeopardise his job and is finding it difficult to access the vaccination before then, but GPs would rather vaccinate in the morning.

[Mr Lansley]

The arrangements that individual GP surgeries make for ordering and administering doses of the vaccine have been, since October, for them to make. From our point of view, as soon as we were aware that local supply would not necessarily match local demand in the places it should, we took the decision last week to make available the NHS stockpile—there are 12.7 million doses of the H1N1 vaccine—and I can tell my hon. Friend that 20,000 doses began to be distributed this morning. There is no reason why we cannot meet the requirement for vaccinations, whether through GPs’ own doses and local arrangements, through issuing NHS prescriptions that can be fulfilled at local pharmacies or through surgeries ordering the H1N1 vaccine from us.

Paediatric Cardiac Surgery

Baroness Morgan of Cotes Excerpts

Wednesday 7th July 2010 Westminster Hall

[Liz Kendall]

I agree absolutely with my right hon. Friend. Many parents and staff are rightly concerned about the implications of travelling longer distances, particularly in emergencies.

I am a former director of the Ambulance Service Network, and I know that paramedics are highly trained professionals—increasingly to degree level—who can provide lifesaving treatment for patients while taking them to specialist centres further away, but that is not always possible, and the review must thoroughly consider the implications of further travel for the lives that could and will be saved.

High-quality care is not just about standards of surgery, the links with other specialisms or the ability to access planned and emergency care. A recent event organised to discuss children’s heart surgery in Leicester was attended by more than 800 parents and former patients, and those present felt that many more people would have attended if the event had not been held mid-week and during working hours.

The families said that the help and support that they get from the nurses, doctors and other staff at Glenfield are outstanding, and the key point that came up time and again was the excellent communication and support provided by the centre. Parents spoke about how staff go the extra mile to explain diagnoses and procedures simply and clearly, often at a frightening and worrying time. Every child gets a diary that explains in a way the whole family can understand what care they have received. It provides something for the children to look back at when they are older.

Parents said that the staff were like members of their own family; they could ring them day or night if they had any concerns. That familiarity with individual patients and families is crucial. All the studies by groups such as the Picker Institute of patients’ experience of care prove that individual, personalised care and communication are vital. One young man said that the staff knew him as a person, not as just another case, and that he was worried that that would be lost in a larger unit or if his care were split between outreach clinics and other centres.

Families also spoke about the fantastic help they get from the Heartlink charity at Glenfield, which has raised money to provide accommodation so that parents can stay overnight with their children, a play area so that brothers and sisters can play while families are visiting the child, and day trips for the patients as they get older. Those wider aspects of care are vital to parents and patients, but are barely mentioned in “The Need for Change”. I urge the Minister to ensure that the review has fully considered those issues when it makes its recommendations.

The final factor that the review of children’s heart surgery needs to take into account is affordability. It must be driven by the need to improve quality, not to cut costs, and, in these financially constrained times, it must acknowledge that there will be costs associated with changing children’s heart surgery in England.

[Nicky Morgan (Loughborough) (Con)]

Like the hon. Lady, I have visited the Glenfield centre, which is close to my constituency. As the parent of a healthy child, I felt humbled by the care that I saw there. The point that she is making about cost is important, because we appear to be achieving neither safer care—there has always been safe care—nor more efficient care. I understand that the reconfiguration would be very expensive, and she speaks rightly about straitened economic circumstances at this time.

[Liz Kendall]

I agree absolutely with the hon. Lady. The costs associated with changing children’s heart surgery centres include not just physically expanding a centre’s buildings, beds and equipment, but retraining staff. When I went to Glenfield, I was told that many of the staff would not move if the centre were changed. It takes time and money to train new staff, particularly in such a specialised area, and the review must take that into account when it makes its recommendations.

--- Later in debate ---

[Mr Burns]

As I said a minute ago, that recommendation is the consensus within the professional bodies. However, I am more than happy to give the hon. Lady a commitment that I will write to her after this debate to elaborate, providing as much extra detail as I can, if she believes that will be helpful.

Turning to the other criteria, the review will also take account of surgical centres’ physical location relative to others and the impact of reconfiguration on other important services, including the highly regarded ECMO or total life support service at Glenfield hospital in the hon. Lady’s constituency, which she described with such eloquence in her remarks. The final part of the review will involve centres’ ability to attract key clinical staff and their families. I hope I can reassure the hon. Lady that transportation options and travel distances will be evaluated, including travel times specifically. The Paediatric Intensive Care Society has advised on the issue, and we continue to investigate and seek advice. I appreciate fully the importance of the issue and the concern that it causes many families.

[Nicky Morgan]

Will the review also consider the impact on other services? For example, at Glenfield, there are two intensive care units for children in the city, and I understand that one team covers both. If the centre were to be closed—this might also apply to other centres—it might destabilise other services within the hospital.

[Mr Burns]

The short answer is that I cannot make that commitment myself. As my hon. Friend will appreciate, the review is independent and will be carried out at arm’s length from the Department of Health and Ministers. I do not have a role, and it would not be correct for me to seek to interfere in the process. However, having said that, I am confident that my hon. Friend’s point will be considered as part of the review, because it will be comprehensive and across the board, considering all aspects of this highly specialised and important health care provision. I hope that reassures her.

The available research evidence suggests that larger surgical centres deliver better clinical outcomes. As cardiac expertise is available round the clock, they can perform a wider range of complex procedures, meaning fewer transfers between centres. Larger centres can still provide a personalised service. The service standards make it clear that tailoring services to the needs of each child is critical. That is an extremely important factor that I know the hon. Member for Leicester West understands and accepts fully.

I also assure the hon. Lady that any changes to local health services will not be driven from the top down. The review has strong support from external organisations. It has been instigated at the request of parent and patient groups, clinicians working in the service and professional associations, including the Children’s Heart Federation, the Royal College of Surgeons, the Royal College of Paediatrics and Child Health, the Royal College of Nursing, the British Congenital Cardiac Association and the Society for Cardiothoracic Surgery in Great Britain and Ireland. It is important to understand that any recommendations on the future number and location of surgical centres will be made not by any central body but by the 10 specialised commissioning groups working with local NHS commissioners. The review will consider access to services for the whole country.

The national specialised commissioning group was asked to lead the review because of its co-ordinating role across the 10 specialised commissioning groups. I am sure that the hon. Lady will agree that that was the most sensible approach to take when the review was devised and set up just over two years ago in 2008. The group was ideally positioned to engage with commissioners and clinicians from across the country.

I reiterate that the review is being undertaken in response to the concerns of parents and professionals about the future capacity and capability of paediatric cardiac services. It will be an open process; I assure the hon. Lady that the outcomes are not predetermined. It is a genuine review seeking genuine answers in order to maintain the highest standards of quality in a specialised and difficult area of patient care. The national specialised commissioning group will set up a consultation process on its recommendations and standards this autumn. We must wait and see what the review says and then go through the consultation process, during which anyone will be able to input their thoughts, recommendations, comments, criticisms or praises of the review’s findings, before any final decisions are taken.

I thank our external partners and their patients for their input to the review so far. I find it encouraging that the review has broad support across the board. As the hon. Lady will accept, children deserve the best possible care. The Government are determined to provide the best paediatric cardiac care possible after the review and consultation processes have been concluded and the final decisions reached.

Question put and agreed to.