Health: Congenital Heart Disease

Baroness Pidding Excerpts

Thursday 20th July 2017 Lords Chamber

[Baroness Pidding (Con)]

My Lords, I join others in thanking the noble Baroness, Lady Boothroyd, for securing this debate. My contribution will be fairly brief. I start by congratulating everyone involved on understanding the need for a set of standards for congenital heart disease, and NHS England on organising two separate groups—one for children, the other for adults—to agree those standards. We should not forget that our NHS congenital heart disease service is a remarkable success, given that being born with this condition in the 1960s suggested a survival rate to the age of 16 of only 15%, whereas those born with the condition today have a survival rate of nearer 90%.

The Somerville Foundation, of which I have recently become a patron, is the UK patient support group for adults with congenital heart disease. It had been calling for a set of standards for adults for more than 10 years and is convinced that these standards will further raise the quality of the service for these patients across the country. It also points out that, for the first time ever, the number of adults with congenital heart disease is higher than the number of children with it, and this number continues to rise.

The Royal Brompton Hospital achieves all the standards for adult congenital heart disease and the Somerville Foundation is extremely concerned about the impact that this proposal will have on adult patients. There is no suggestion that the Brompton does not provide a world-class service for congenital heart disease. It is recognised around the world for its care, technology, clinicians and research.

We are now at the stage where the public consultation on congenital heart disease surgical services has ended. Therefore, only now can the difference between the cold interpretation of the standards and the outcomes of implementing them be fully considered. NHS England was right to consult, as it had to measure services against the standards it was given. The Brompton, it is suggested, fails one of the children’s standards. Of course, it would be best if this was not the case, and it was able to comply in some way. However, the proposals would have such an impact on the adult service that the cost would be greater than the gain. Already around the country, including in London, the demand for adult congenital heart services outstrips the supply and, as I have already said, the demand is getting larger due to better survival rates.

The other two London specialist centres, Bart’s and St Thomas’, are already fully stretched in providing the specialist care for these patients. While the long-term aim of having fewer, larger centres is understandable, it would be better achieved by combining centres. It is difficult to understand how the transfer of thousands of patients within an already stretched service in London can provide improved patient experience. Once the responses of the public consultation have been considered, as well as the impact of the proposed change at the Brompton, I am sure that the only conclusion can be that the Brompton must retain its adult congenital heart service.