NHS: Children’s Congenital Heart Services

Earl Howe Excerpts

Thursday 25th October 2012 Lords Chamber

[The Lord Bishop of Leicester]

To ask Her Majesty’s Government why the removal of extracorporeal membrane oxygenation equipment from Glenfield Hospital does not form part of the review by the Independent Reconfiguration Panel into children’s congenital heart services in Leicestershire, Lincolnshire and Rutland.

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe)]

My Lords, the Independent Reconfiguration Panel—the IRP—provides advice to the Secretary of State on the plans that the NHS puts forward for significant change to services. The legislation does not allow it to review decisions taken by the Secretary of State. My right honourable friend the Secretary of State has asked the IRP to review the Joint Committee of Primary Care Trusts’ decision on the future pattern of children’s congenital heart surgery and its consideration of the impact of that, which may include possible consequences for this service at Glenfield.

[The Lord Bishop of Leicester]

My Lords, I am grateful to the Minister for his Answer. In the east Midlands we appreciate the Secretary of State’s decision to review his predecessor’s decision on the future of children’s congenital heart services in Leicestershire, Lincolnshire and Rutland. However, in view of the unique and exceptional network of expertise with a world reputation supporting the so-called ECMO unit—expertise that, once dismantled, would be very difficult to reassemble—does the Minister accept that its future is inextricably linked to the future of children’s congenital heart services? Will he give an undertaking to this House that he will press that point on the Secretary of State?

[Earl Howe]

My Lords, I accept that there are interdependencies between the provision of children’s cardiac surgery and the children’s ECMO service. If new evidence emerges or there are exceptional circumstances, such as a change in circumstances following either the Independent Reconfiguration Panel review or any judicial review that may occur, then my right honourable friend the Secretary of State may wish at a future time to review the earlier decision.

[Lord Bach]

Is the Minister aware of how absurd it would be to have an independent report on the future of the heart unit but to exclude any consideration of the fate of the ECMO unit? As the right reverend Prelate said a few minutes ago, they are inextricably linked; indeed, the Minister seems to have conceded that there is a link between them. I remind him that Members of another place from all parties and from different parts of the country made it clear in their excellent debate earlier this week that the two are linked. As the Minister’s right honourable and learned friend Sir Edward Garnier said:

“We all know that the current decision is wrong and needs to be dealt with”.—[Official Report, 22/10/12; col. 188WH.]

Will the Government please look at this again before the whole country—

[Lord Bach]

I think this is a question. Will the Minister please look again at this before the whole country loses an outstanding part of our National Health Service?

[Earl Howe]

My Lords, I hope that my initial Answer will have made it clear that we expect the Independent Reconfiguration Panel to look at the issue in the round, and that includes the consequences of the JCPCT’s decision, were that to be carried through. I hope that that is sufficiently reassuring. However, what the panel cannot do, in law, is review the decision of the Secretary of State. It can, however, take all the circumstances into account, and I believe that it should do so.

[Lord Hunt of Kings Heath]

My Lords, I remind the House of my health interests in the register. I would like to press the Minister on that point. In the other place on 22 October, the Minister there made it clear that the decision to transfer the ECMO to Birmingham was made as a consequence of the decision of the Joint Committee of Primary Care Trusts. Given that the Independent Reconfiguration Panel is now reviewing the decision of the Joint Committee, are the Government not being unnecessarily legalistic on this point? It would be quite open to the Secretary of State to ask the reconfiguration panel for its advice on the question of the ECMO position. Why on earth does he not do that?

[Earl Howe]

My Lords, I can only repeat what I said in my initial Answer to the right reverend Prelate: my right honourable friend has asked the IRP to review the decision around children’s cardiac services and its consideration of the impact of that, which may include consequences for the ECMO service at Glenfield. I hope that that Answer puts this question into context. While the IRP cannot review the Secretary of State’s actual decision about the ECMO, which, as the noble Lord rightly said, followed on from the original decision of the JCPCT, nevertheless there are interdependencies between the two services that we expect to be taken into account by the panel.

[Lord Walton of Detchant]

My Lords, may I express the hope that this review will be concluded speedily? The whole issue of the facilities for paediatric cardiac surgery across the UK has been under consideration for about two years. I have an avuncular interest, of course, in the future of the cardiac unit in the Freeman Hospital in Newcastle, which is one of the most outstanding in the country. I ask for a speedy conclusion because the whole organisation and reorganisation of cardiac paediatric surgery have to await the Secretary of State’s decision.

[Earl Howe]

The noble Lord, as ever, makes an extremely important point. Children’s heart surgery has been the subject of concern for more than 15 years. Clinical experts and national parent groups have repeatedly called for change, and there is an overwhelming feeling that the time for change is long overdue. I accept the noble Lord’s point that a decision should be reached as speedily as possible. I am advised that the IRP will report to the Secretary of State on 28 February 2013, or following the conclusion of any judicial review if such a review takes place.

[The Lord Bishop of Leicester]

My Lords, is the Minister aware, in spite of the technically clear Answer that he has given, that the overwhelming medical opinion is that the removal of this unit could lead to significant loss of children’s lives? Are he and the Secretary of State able to contemplate that possibility with equanimity?

[Earl Howe]

My Lords, of course I do not regard any possibility of children losing their lives with equanimity. I can only say that that aspect was carefully looked at by the JCPCT with strong clinical advice. It reached the conclusion that it would be safe to move the ECMO service to Birmingham.