Health Protection (Coronavirus, Restrictions) (Leicester) Regulations 2020

Lord Garnier Excerpts

Wednesday 29th July 2020 Lords Chamber

[Lord Garnier (Con) [V]]

My Lords, in this short contribution I need to remind myself that, although I was the Member of Parliament for Harborough for 25 years, since 2017 that constituency has been ably and diligently represented by Neil O’Brien. His constituents are more than fortunate to have him as their MP, and I could not have wished for a better successor.

Part of the constituency, the borough of Oadby and Wigston, covered by the LE2 and LE18 postcodes, is still included in the area covered by these regulations. It is wholly within the Harborough constituency, but has a three or four-mile border with the city of Leicester to its south and east. While politically—and in many other ways—wholly distinct from the city of Leicester, thousands of residents in the borough work in or have connections with the city. Many Leicester families send their children to the excellent state and private schools in the borough and in rural Harborough. There is a huge amount of social and business travel between the city and the borough. Many of the textile businesses in the city are owned by residents of the borough and a great many students at Leicester and De Montfort Universities, both of which are within the city, live in halls of residence and other accommodation in the borough. The three NHS hospitals in the city—the Royal Infirmary, the General and the Glenfield—employ staff and treat patients resident in the borough.

Therefore, what happens in the city affects the borough, even though the borough is not the city and the city is not the borough. In his article in the New Statesman dated 24 July to 13 August, Professor Robert Colls of De Montfort University reports that in Leicester there were 141 cases per 100,000 people for the week ending 28 June and 119 new cases per 100,000 people on 16 July, compared to a UK average of 13.2. The Minister’s figures were slightly different, and he tells us that they are now down to 64 per 100,000. However, while the residents of the borough, and of Harborough more widely, appreciate the general dangers of a resurgence of Covid-19, they are also entitled to a clear explanation of why their community is being brought in or out of local lockdown measures. In the city, the highest infection rates are in the most deprived and overcrowded council wards. There are no such wards in Oadby, but—

[Baroness Penn (Con)]

My Lords, we are very tight for time. Can my noble and learned friend bring his remarks to a close?

[Lord Garnier [V]]

If the demographic information given by my noble friend Lord Ribeiro is correct, there needs to be some sort of framework, as there is in other countries, to explain to people why decisions taken 100 miles away in London are necessary. At the moment, for example, people have no idea of where rates of infection need to fall to for them to be released from lockdown.

Glenfield Hospital Children’s Heart Surgery Unit

Lord Garnier Excerpts

Wednesday 19th October 2016 Westminster Hall

[Liz Kendall (Leicester West) (Lab)]

I beg to move,

That this House has considered the future of Glenfield Hospital’s Children’s Heart Surgery Unit.

It is a pleasure to serve under your chairmanship, Mrs Gillan. The future of Glenfield’s children’s heart surgery unit is a hugely important issue not only for my constituents and patients in the east midlands but for people across the country—Glenfield currently serves patients from 296 parliamentary constituencies. The Minister will know that 34,000 people have signed an online petition to save the unit, and I understand that many thousands more have signed the paper petition. That shows the strength of local feeling.

Like the hospital, I support NHS England’s desire to achieve the highest possible standards for children’s heart surgery across the country. NHS England’s standards rightly state that it must be able to

“reserve the right not to commission services from a provider that is so significantly at variance from the standards as to cause safety/quality concerns. Such a decision would only be taken following a risk assessment of the costs and benefits of both closure and non-closure.”

However, there is no evidence that Glenfield is at significant variance from the standards—in fact, quite the opposite. According to independent assessments, Glenfield has among the best clinical outcomes in the country, including for mortality rates and readmission rates, which are significantly lower than those in other centres. Clinicians at Glenfield rightly say that it makes no sense to close a centre that is already achieving precisely the good clinical outcomes NHS England wants.

[Sir Edward Garnier (Harborough) (Con)]

I congratulate the hon. Lady on achieving this debate, which continues the public debate we have been having in the county and the city in respect of the hospital. Does she agree that the hospital and its children’s heart unit not only has a regional and national reputation of the highest order but is a world centre of excellence, and for it to be closed or for any of its services to be decreased would be little short of wanton destruction? I urge her to urge the Minister to take that message firmly back to his Department.

[Liz Kendall]

I completely agree with the right hon. and learned Gentleman. I am sure that not only the 57 patients from his constituency who are currently receiving treatment but the thousands of patients who receive ongoing care, including for extracorporeal membrane oxygenation, which I will come back to, rightly value the high standards at Glenfield. It would be a huge and terrible mistake to close the centre.

In a recent letter to the hospital, NHS England raised concerns that more complex cases are being referred to Birmingham from Glenfield. I take issue with that. I would like the Minister to confirm that, in fact, only four such cases have been referred to Birmingham in the past three years, and that it is a professional obligation to seek second opinions when that is in the best interests of patients. That is enshrined in General Medical Council good practice guidelines and was recommended by the paediatric and congenital services review group in its recommendations in 2003. Few complex cases are referred but, when they are, it is in the best interests of patients. That should not be used as a reason to close the unit.

A second part of the standards that NHS England has set out is ensuring that sustainable numbers of children have surgery in each unit every year. The aim is to have 375 operations per year over the next three years, with 500 a year in the longer run. I want to make this clear: the hospital has told me and NHS England that it is on track for 375 cases this year and that, if it does not quite achieve that, it will not be by significant numbers. It therefore rightly asks: “Why put a centre on track to reach those standards at risk by this proposal?”

On the longer term goal of achieving 500 cases a year, there is an important question. More than 500 children in the east midlands need congenital heart surgery every year but do not all go to Glenfield. NHS England claims that that is due to patient choice. Some patients in Peterborough or Northampton will choose to go to places such as Great Ormond Street, but the claim that all patients in Northampton choose to go to Great Ormond Street while all patients from Peterborough choose to go to Leicester suggests the goals are more about historic referral patterns than about genuine patient choice.

--- Later in debate ---

[Liz Kendall]

Absolutely. It would be a big mistake and it does not have to be this way. The unit is improving its care. It already has some of the best outcomes in the country. If we manage the referral patterns, we can ensure that Glenfield and other units continue to improve their care and support. I am sure that the 41 patients from the hon. Lady’s constituency who are currently being treated at Glenfield will appreciate her speaking out.

UHL is one of five tier 1 providers of acute specialised services in the midlands and the east region. Our amazing paediatric intensive care unit is part of a network of centres covering 17 million people. Any significant change in the number of children with complex heart problems being moved away from UHL will have a serious impact on the PICU and destabilise the network. That is not my view—I am not a clinician—but what the clinicians in the hospital tell me, yet so far NHS England has failed to publish any risk assessment of those knock-on effects on Glenfield’s ECMO or paediatric intensive care. The continuing uncertainty about the unit is terrible for the clinicians who are working there and trying to improve care. The threat of closure may be one of the reasons why it is not receiving as many referrals as it normally would, but it is also deeply destabilising for the families whose children need ongoing care and support.

[Sir Edward Garnier]

I am grateful to the hon. Lady for letting me intervene on her twice. I concur with the point she made: the situation makes it very difficult to attract clinicians, nursing staff and technicians to such a hospital. We need the expertise but, if there is a state of confusion or uncertainty, things become more difficult. I know that my hon. Friend the Member for South Leicestershire (Alberto Costa) wanted to make that point—he has many constituents who work in or use the hospital—but unfortunately, owing to parliamentary business, he was unable to be here at 11 o’clock.

[Liz Kendall]

I know the hon. Member for South Leicestershire (Alberto Costa) would have spoken up on behalf of the 94 patients in his constituency who are receiving ongoing care and support.

It is a miracle that Glenfield is providing such incredible standards of care when it has been under the cloud of uncertainty for so many years. It makes no sense to close a unit whose clinical outcomes are already among the best in the country. It makes no sense to deny choice to hundreds of patients who are treated or want to be treated at Glenfield, and their families, when, if services worked together to achieve the number of referrals that we need, our unit and others could benefit and improve. It makes no sense to leave the east midlands as the only region in the country without a children’s heart surgery unit, or to put at risk a world-leading ECMO unit and a vital, high-quality paediatric intensive care unit that supports millions of patients across the midlands and the eastern region.

The Government must think again. They must look in detail at the current evidence from the hospital about its outcomes; they must listen to the views of patients; and they must balance all of those issues—high-quality surgery, ongoing care and support, the knock-on effect on other services and whether other units in the country would be able to treat all those extra patients before they have made huge improvements, which will take time. It does not make sense. It does not have to be this way. We can work together to save the unit and improve care for everybody.

NHS: Learning from Mistakes

Lord Garnier Excerpts

Wednesday 9th March 2016 Commons Chamber

[Mr Hunt]

The right hon. Gentleman is absolutely right that the fear of litigation has a very pernicious effect, which we see across the NHS. Litigation is a huge drag on costs and we are reforming how it works. We have looked at what happens in other countries. In Sweden, for example, the creation of a no-blame culture has had the dramatic impact of reducing maternity and neo-natal injury. I hope that today’s statement is a step towards that, but we will consider other reforms to the litigation process as well.

[Sir Edward Garnier (Harborough) (Con)]

The Under-Secretary of State for Health, my hon. Friend the Member for Ipswich (Ben Gummer), and I had a useful debate this morning in Westminster Hall about clinical negligence cases, and what the Secretary of State has said this afternoon clearly touches on that. I might be being obtuse, but the statement seems to relate to the internal investigation of the poor or mistaken conduct of doctors by the disciplinary system, and not to the resistance to, or the conduct of, clinical negligence cases. I hope I am wrong about that, because we do not want, despite the best of intentions of the Secretary of State, as identified in the statement, to make the settlement of just clinical negligence cases more difficult, more expensive and more sclerotic. I read in the papers this morning that there would be a need for a court to give consent to the use of particular information. It might well be that this morning’s trails were inaccurate and do not reflect what the Secretary of State intends, but I wonder whether he could disentangle internal and external reactions to poor conduct.

[Mr Hunt]

I shall do my best for my right hon. and learned—and eminent—Friend. We do not want to affect the legal rights of anyone who wishes to litigate against the NHS because they feel they have been treated badly. Those rights must remain, and we will protect them, but we want to make it easier to get to the truth of what happened so that we can learn from mistakes. The information uncovered by a healthcare safety investigation branch investigation could not be used in litigation proceedings without a court order. However, my belief is that having those investigations carried out by the branch is quite likely to speed up court processes, because I think it will establish on all sides, in greater likelihood, agreement about what actually happened in any particular situation. I hope that that will be beneficial, but if anyone wants to use the evidence in litigation, they will have to re-gather it, because we are concerned that, if doctors are worried that anything that they say could be used in litigation, they may be hesitant about speaking openly, and that represents the defensive culture that we are trying to change.

Clinical Negligence Claims

Lord Garnier Excerpts

Wednesday 9th March 2016 Westminster Hall

[Sir Edward Garnier (Harborough) (Con)]

I beg to move,

That this House has considered the Government’s proposals on fixed recoverable costs in clinical negligence claims.

Thank you, Mr Nuttall, for presiding over this very short debate. I thank Mr Speaker for granting it and my hon. Friend the Minister for being here to respond on behalf of the Government.

I should make it clear at the outset that, although I am a barrister in private practice, my work does not include clinical negligence cases, so I have no personal interest in this subject. I have, however, been approached by a number of solicitors from Leicestershire, the Leicestershire Law Society and the Law Society of England and Wales. They are concerned that the Government’s consultation on the fixed fee regime, which is being conducted by the Department of Health, has been delayed, although I understand that the Government intend to introduce a fixed recoverable cost regime in October. Those concerns are shared by a number of other solicitors’ firms, including Irwin Mitchell and Slater and Gordon, and organisations such as the Association of Personal Injury Lawyers, the Society of Clinical Injury Lawyers and the Bar Council. I am grateful to all of them for the assistance they have given me in preparing for this short debate.

Let me begin by placing my concerns in context. On the face of it, the Secretary of State’s statement, which has been trailed in the press—apparently, he is going to make a statement in the House of Commons this afternoon—confuses punishment, which is dealt with under criminal law, and civil law remedies, but no doubt he will make himself clearer this afternoon. Perhaps my hon. Friend the Minister can clarify that issue briefly this morning.

I accept that the Government do not have a bottomless purse. Taxpayers’ money is needed to pay for a huge range of public services, all of which compete for scarce resources at a time when the Chancellor is trying to balance the books and decrease public expenditure.

[Nick Thomas-Symonds (Torfaen) (Lab)]

Will the right hon. and learned Gentleman give way?

[Sir Edward Garnier]

I will not give way.

That this debate takes place only a week before the Budget underlies that point. I further accept that the vast majority of patients who visit a GP, an NHS surgery or a hospital leave satisfied with their treatment and the outcome, but very occasionally something goes wrong. In just over 3% of those cases an error caused by a negligent decision or act of omission by a clinician leads to a claim being made by the injured person against the NHS. Such cases can include, for example, birth injuries or misdiagnosed or mistreated illnesses. Of course, those are not deliberate actions by ill-motivated doctors or nurses, but negligent ones that lead to adverse consequences for the patient.

What does 3% mean numerically? In 2011-12, the NHS reported just under 420,000 so-called “adverse incidents causing harm”, of which 13,500, or just over 3.2%, resulted in a clinical negligence claim. In the following year, there were just over 458,000 such incidents and 16,000 claims, or about 3.5%. In 2013-14, there were just over 470,000 incidents and just under 18,500 claims, or 3.9%. In the great scheme of things, those numbers are small, but they represent permanently damaged or shortened lives, pain, suffering, heartache and anguish.

Of course, they also represent monetary expense to the claimant and the NHS. We should therefore aim to ensure justice and proper compensation for the claimant who has been injured, and protect the taxpayer from excessive and unnecessary expense in legal and medical experts’ fees.

[Mr Pat McFadden (Wolverhampton South East) (Lab)]

Will the right hon. and learned Gentleman give way?

[Sir Edward Garnier]

I regret that I cannot; this is a half-hour debate, and I am afraid we are rather pushed for time.

It is uncontroversial to state—and the common law expects this—that damages should, as far as they can, put the injured party back where they were before the incident. We need a system that does not prevent the bringing of justified claims and encourages excellence and proportionality in the conduct of each claim, as well as in the conduct of the defence. An efficiently and expertly brought claim saves money, as it leads to the real issues being considered within a suitable timeframe. It allows the defendant to focus more quickly on what they need to do to satisfy the claim and not waste time and money on irrelevant or hopeless points.

Any changes that the Government intend to impose should not be retrospective—that is a basic rule of fairness —and must be even-handed. The Treasury must be an umpire and not a partisan ally of the Department of Health, because in the long run a poor set of reforms will lead to greater expense, not less, and a lessening of public trust in the NHS and the Department. Given that the Department of Health is managing the consultation and is the most common defendant in clinical negligence claims, it is difficult—despite, I hope, the construction of very high Chinese walls—to think of this as a wholly disinterested exercise.

It is easy to say—although it is not so easy to accomplish this—that the best way to reduce the number of clinical negligence claims against the NHS is to reduce the incidence of medical negligence. That is no doubt a statement of the blindingly obvious, but it may occasionally get forgotten as the Government look for ways to cut expenditure. Let us start by improving the training and decision making of those in the NHS who are statistically most likely to do things that lead to clinical negligence claims.

Let us also remember that the Legal Aid, Sentencing and Punishment of Offenders Act 2012 automatically cut the costs and expenses paid out by the NHS Litigation Authority by about a third, and that for claims worth less than £25,000 those savings come to 39% of the costs budget, or £71 million a year. In the NHSLA’s annual report of 2014-15, the chairman asserts that more than a third of the NHSLA’s spending was received by the legal profession, and most was paid to claimant lawyers. In fact, the report shows that the NHSLA’s operating costs amounted to £2.64 billion, of which £291.9 million, or 11%, was paid to claimant lawyers and £103.2 million, or 4%, to defence lawyers.

The report’s figures suggest that 15% of the LA’s spending is paid to lawyers, but there is no breakdown of what that number includes. The report indicates the LA’s net operating costs reduced from £3.373 billion to £2.641 billion between 2013-14 and 2014-15—a reduction of £732 million. It also says that claims reported to the LA reduced from 11,945 in 2013-14 to 11,497 in 2014-15—a reduction of 3.7%. The amounts paid out in damages reduced from £840.7 million in 2013-14 to £774.4 million in 2014-15—a reduction of 7.9%.The NHS has therefore achieved significant reductions in expenditure. The NHSLA also reports an increase in sums paid to claimant lawyers for costs and disbursements from £259 million to £292 million between 2013-14 and 2014-15. The average cost per case increased from £16,852 to £17,735—an increase of 5.2%.

There is inadequate analysis of those figures, and the report is, to that extent, misleading. The NHSLA claims to have

“saved over £1.2 billion…in rejecting claims which had no merit.”

However, as claims without merit always fail, those savings are illusory. It cannot claim to have saved money it would never have spent. The authority also claims that £38.6 million was saved by taking a significant number of cases to trial, but it does not say how much was spent unsuccessfully contesting cases at trial or settling cases soon before trial.

The NHSLA refers to the levels of costs recovered by claimant lawyers without distinguishing between costs and expenses. It compares the level of costs incurred by different sides without noting that the burden of proof requires claimants to undertake much more work than defendants. APIL says that nearly half of what the NHSLA says it pays out in legal costs to claimants’ lawyers are accounted for by success fees on conditional fee agreements, after the event insurance premiums, court fees and expert witnesses’ fees. Much of that could be saved if the NHSLA were better at its job of settling the claims it ought to realise it will lose on liability from or close to the outset.

That said, not all medical negligence claims are straightforward, but proving what went wrong is not made easier for a claimant’s lawyer when the NHS holds all the information and is reluctant to disclose it. On far too many occasions, cases that could have been settled more quickly, cheaply and satisfactorily are not, because the NHSLA withholds information, does not respond in good time to requests for information, or simply fails to apply its collective mind to the best way of dealing with the complaint. I have lost count of the number of times that I, as a constituency Member of Parliament, have corresponded with a hospital, insurance company or some large institution, private or public, that, when faced with a complaint, has buried its head in the sand and hoped that it will go away.

Most complainants just want someone to take responsibility and say sorry, and are not after money or revenge. That applies to the bereaved parents of stillborn babies as much as it does to the adult children of an elderly patient who died after a fall from a hospital bed, or who lay for days in agony because of untreated bed sores. The defensive failure to apologise often causes more heartache than the negligence itself and causes claimants to believe that they have to sue to get justice.

In addition, the NHSLA too often engages in unproductive trench warfare: it must not be seen to be giving ground, so the order goes out: “Deny, defend, delay!” Cases that could have been resolved months and sometimes years earlier end up being settled at the door of the court, or lost after a trial, by which time advocates’ brief fees have to be added to all the other costs that have piled up unnecessarily since the complaint was first raised. If ever there was a need for a patient to heal himself, it is the NHSLA in its refusal to free itself from the indefensible, or to see the wood for the trees. Rather than too often denying, defending and delaying in the wrong cases, it should assess, admit and apologise in the right cases.

An example of that is in the failure to look for and to release medical records. Requests for records should be met under the Data Protection Act 1998 within 40 days, and under Government guidelines for healthcare organisations within 21 days. Far too often both deadlines are missed, and not by a whisker, but by a country mile. It can often take more than six months for claimant lawyers to get patients’ records from GPs and hospitals and, with a limitation period of three years to bring a claim, pressure mounts to issue proceedings to protect the claim. It is not unheard of for long-delayed medical records to show that the claim is unwinnable, so it is dropped—but why not send out the records within a month and save the time, the expense and the anguish?

The NHS is a hydra-headed organisation and, when dealing with medical negligence claims, that can lead not to the proper use of decision-making powers at the most local level, but to procrastination, duplication and more expense. Some NHS trusts have in-house legal departments and when they receive a claim pass it directly to the NHSLA; some hold on to them and pass them on much later. My informants from the legal profession tell me that trusts’ legal teams are far less settlement-minded and tend to use every point, good, bad and indifferent, to string the claimant along. If a case gets towards trial, the NHSLA instructs outside lawyers. Why not make it a matter of policy for all claims to be handed straight over to the NHSLA, and thus minimise, even if not abolish, delay and unnecessary costs?

Finally, I want to urge the Government to reconsider their proposal that all clinical negligence cases up to a value of £250,000 should be low-value claims. First, in any view, £0.25 million is not a low-value claim either to the claimant or to the taxpayer, not least when one considers how many there are every year.

Secondly, to take just one example, hundreds of babies are left brain-damaged every year because the NHS has treated them negligently either before or after birth and, sadly, some of them die soon after birth. A claim brought by the parents of a child who has died aged a few hours, days or weeks will not of itself lead to a large award of damages, but the evidential route to determining where liability lies for the acts or omissions that led to that premature death can be highly complex in investigation and assessment. The same legal costs may be incurred in proving a claim, whether it is of low or of high value.

For instance, in a case of delayed cancer diagnosis, the same expert evidence may be required where a patient’s life expectancy has been reduced by two years and the award is £30,000, or where life expectancy is reduced by 50 years and the case is worth £500,000. Those worst affected will be the most vulnerable—the elderly, those on low income and people with disabilities.

On 13 January, in answer to my written questions Nos 21040 and 21037, the Minister accepted, unsurprisingly, that there is no exact correlation between the value and complexity of clinical negligence claims, and it must therefore follow that to impose an artificial limit on the amount of costs recoverable by the claimant based only on the quantum of damages could lead to injustice, especially when the NHSLA will not be equally constrained.

Already claimant law firms reject 90% of inquiries in this field and the proposed fixed-fee regime for cases of up to £250,000 will simply dissuade firms from assisting even more claimants. As one experienced Queen’s bench master who specialises in such cases recently said, further research is

“essential in order properly to understand the impact on access to justice of the existing system of funding before implementing any further changes.”

A fixed-costs system for claims under £250,000 would affect 95% of cases and make many meritorious claims unviable for patients, undermining the legal and the medical systems. That would not be in the interests of justice, of medicine, of the economy or of the country, and we need to think again. The Minister is a thoughtful man, and I am sure he will want to give a thoughtful response, today and subsequently.

Oral Answers to Questions

Lord Garnier Excerpts

Tuesday 10th June 2014 Commons Chamber

[Norman Lamb]

I know that my right hon. Friend has been campaigning for that hospital. I welcomed the comments of the chief executive of NHS England, who has argued for a much more flexible and adaptable NHS, and for ensuring that GPs locally, working with community services, can offer the maximum range of health services to the local community as close to them as possible.

[Sir Edward Garnier (Harborough) (Con)]

Two and a half years ago, my right hon. Friend the Member for Chelmsford (Mr Burns), then Minister of State, opened the St Luke’s hospital day care unit in Market Harborough, which serves a large rural area in my constituency. During those two and a half years it has been open for only 131 days, which is a huge waste of public money. I wrote to the Secretary of State yesterday. He will not have had a chance to read my letter yet, but will my hon. Friend and his colleagues look into the matter, and ensure that we do not waste public money on opening hospitals that do not provide a service?

[Norman Lamb]

My hon. and learned Friend has raised an extremely important point. It is essential that the maximum possible use be made of investment. I know that the Secretary of State will look into this issue when he has received the letter, but we must ensure that all such facilities are properly used.

Children’s Heart Surgery

Lord Garnier Excerpts

Wednesday 12th June 2013 Commons Chamber

[Mr Hunt]

That is entirely right. On this occasion, it is clear that the concerns of the campaigners were valid, and that the process was not conducted as it should have been. Interestingly, the campaigners commented that they felt that their engagement with the IRP was a much more open process than their engagement with the NHS.

Many people in the NHS believe passionately, and for absolutely the right reasons, that we need to change the way in which services are delivered. I agree with them, and specialised services such as those that we are discussing today provide a very good example of that. We know that the more operations a heart surgeon performs, the better he or she will become at his or her job, and the more likely a successful outcome is. However, if we are to carry the public with us—and they are, after all, the people whom the NHS is there for—we must do a much better job of genuine engagement.

[Sir Edward Garnier (Harborough) (Con)]

I thank the Secretary of State for an intelligent and thoroughly considered statement which will have brought great joy to many people in Leicestershire. I also commend the shadow Secretary of State for dealing with the matter on a cross-party basis. We in Leicestershire have dealt with it on that basis as well: my hon. Friend the Member for Loughborough (Nicky Morgan) and the hon. Member for Leicester West (Liz Kendall) have been, if I may say so, the leading ladies in the Glenfield hospital campaign.

I am grateful for the respite that we are being given by the Secretary of State. What advice can he give us to give to the clinicians, nurses and parents of patients at Glenfield hospital about how best to present, or re-present, their case between now and the time at which he and his advisers will reach a final conclusion about the disposition of children’s heart services?

[Mr Hunt]

We must all engage with the process thoroughly and fully. We, as Members of Parliament, have a responsibility to engage with our constituents about some of the complexities involved. The issue of mortality rates, which was raised by the right hon. Member for Leigh (Andy Burnham), is one of those complexities. They are very important, but they are not the only consideration, and, when it comes to specialised services, they are extremely difficult to interpret properly. We must engage in an intelligent and constructive way, and reassure our constituents that all of us—Government and Opposition—want the best outcome for children, the outcome that will save the most children’s lives.

Let me return to what the Prime Minister said earlier. I have no problem with explaining to my constituents that in the case of certain services, they are better off travelling further. I did not respond earlier to the right hon. Gentleman’s point about travel, so let me say now that I agree with him that it must be taken into consideration. According to the IRP’s report, the whole care pathway needs to be examined. That means not just the visit to the hospital for surgery, but follow-up care and early assessments. In that context, travel becomes much more important.

If we are honest with our constituents about the fact that there may be a difficult decision at the end of the process, we are much more likely to earn their trust.

Heart Surgery (Leeds)

Lord Garnier Excerpts

Monday 15th April 2013 Commons Chamber

[Mr Hunt]

I am afraid the hon. Gentleman has let the Labour party down with the total inadequacy of that response. He spoke of an irresponsible and disproportionate decision, but I ask him to reflect on that as someone who would like to be a Health Minister. Would he seriously have wanted anything different to happen? If the NHS nationally is informed of data that show that mortality rates at a particular hospital could be up to three times higher than they should be, would he sanction the continuation of surgery, or would he say, “We need to get to the bottom of the statistics before deciding whether there will be any more operations”? If he is saying that he would have wanted surgery to continue, I put it to him that he and his party have learned nothing from the lessons of Bristol and nothing from the lessons of Mid Staffs. I did not authorise the decision, but wholeheartedly supported it because it was an operational decision made by NHS England. It is right that such decisions are made by clinicians, who understand such things better than we politicians do.

On reconfigurations, the hon. Gentleman’s party closed or downgraded 12 A and Es and nine maternity units in its period in office. The shadow Health Minister, the hon. Member for Leicester West (Liz Kendall), has said that Labour would not fall into the “easy politics” of opposing every single reconfiguration, but that is exactly what the Opposition are doing. It is not just easy politics; it is what Tony Blair last week called the “comfort zone” of being a “repository for people’s anger” rather than having the courage to argue for difficult reforms.

[Sir Edward Garnier (Harborough) (Con)]

My right hon. Friend mentioned at the outset of his response three principles, the first of which was to do no harm. Following discussions that he and I have had—I am sure he has had such discussions with our hon. Friend the Member for Loughborough (Nicky Morgan) and no doubt other Leicester and Leicestershire MPs—does he agree that there is a read-across from Leeds to Glenfield, where we have the Leicester children’s heart unit? It is unquestionably a unit of international repute and certainly one of national repute. The death rates for that hospital, which deals with particularly difficult patients and highly complicated operations, are right at the top. I urge him to learn from the Leeds fiasco—I do not put the fiasco at his door—that the Glenfield hospital should be preserved for the good of the nation and of the people of the east midlands, so that we do no harm.

[Mr Hunt]

I am grateful to my hon. and learned Friend for his question. I am waiting to hear advice from the Independent Reconfiguration Panel on its assessment of the Safe and Sustainable review. I will wait until I get that advice before making any decisions, and in particular before making any decisions on Glenfield, Leeds or any other hospital involved.

It is important to recognise, however, that there two separate issues: the first is the mortality rates at particular hospitals, but the second is whether we can improve mortality rates overall by concentrating surgery in fewer hospitals. I will wait to hear from the IRP on both before making any decisions.

Sudden Adult Death Syndrome

Lord Garnier Excerpts

Monday 25th March 2013 Westminster Hall

[Steve Rotheram (Liverpool, Walton) (Lab)]

I beg to move,

That this House has considered the e-petition relating to preventable cardiac deaths arising from Sudden Adult Death Syndrome.

I shall explain the slight typographical error in the motion in a second, but Mr Amess, you will have to excuse me if, at times, my throat is a little raw; that, and my slightly delicate disposition when standing or sitting, can be explained by the fact that I and my right hon. Friend the Member for Leigh (Andy Burnham) took part in a charity bike ride from Salford to Liverpool yesterday for the Love Leah charity. We are both suffering, but it is a pleasure to serve under your chairmanship this afternoon.

I thank colleagues on the Backbench Business Committee for agreeing to hear my application on behalf of the Oliver King Foundation and for providing time in the busy parliamentary schedule for what I hope will be a preliminary debate, with a full debate in the Commons Chamber before the summer recess. Today’s motion enjoys the support of 65 MPs from seven different political parties and every region of England, Scotland, Wales and Northern Ireland. Some Members, such as my hon. Friends the Members for Halton (Derek Twigg)and for Liverpool, Wavertree (Luciana Berger), have expressed their disappointment at not being able to be here in person, but they send their full support.

I will use my introductory contribution to set the scene and set out a number of specific areas. Today’s debate is the result of the sterling work by the OK Foundation in setting up an e-petition that attracted more than 110,000 signatures. That is no mean feat—getting 100,000 people to sign any petition is impressive, and it shows the dedication of those involved. I would like to place on record my gratitude to the family and friends of Oliver King, to Councillor Jake Morrison, to Dr Zafar Iqbal of Liverpool FC and to the many committed volunteers who have worked tirelessly to support the OK Foundation’s campaign. It is true to say that we would not be here today were it not for their outstanding efforts.

Unite the Union, the GMB, and the National Union of Teachers have also pledged support for the campaign, and I thank them for their very welcome backing. I also thank our local radio stations and in particular Pete Price and Tony Snell for all they have done to raise awareness of the OK Foundation’s relentless campaign, and to Marc Waddington of the Liverpool Echo for his comprehensive coverage of the issue.

I know colleagues will talk in more detail about the OK Foundation, but I would like briefly to pay tribute to the parents of Oliver King, who have used the tragic death of their beloved son as a mechanism to achieve what they hope will be a lasting and inspiring legacy. Oliver was just 12 years of age when he died of sudden arrhythmic death syndrome. He excelled at sport, but his family were totally unaware of his condition until they received the tragic news of his death in March 2011. Quite simply, Oliver could have been saved if an automatic external defibrillator had been to hand. However, despite their utter devastation at the loss of their child, Mark and Joanne decided to try to prevent other parents from having to go through the same heartache that they had, which has led them here to Westminster and today’s debate, and to their request for the Government to act.

[Sir Edward Garnier (Harborough) (Con)]

I am most grateful to the hon. Gentleman, not only for allowing me to intervene, but for securing the debate. A moment ago, he mentioned a number of hon. Members who could not be here. May I take the opportunity to do something for my hon. Friend the Member for Loughborough (Nicky Morgan), who cannot speak in the debate by virtue of being a Government Whip? She has a constituency case that mirrors the one the hon. Gentleman describes—that of Joe Humphries, a 14-year-old who died on a training run last October. The tragedy for the family is indescribable, but his father has set up the Joe Humphries Memorial Trust, and a community launch will take place at Rothley parish church on 13 April. I know that they will draw a great deal of comfort and support from the words of the hon. Gentleman and from this debate, and they will know that this House is deeply concerned about this sort of tragic incident.

[Steve Rotheram]

I thank the hon. and learned Gentleman for his contribution. Until I did some research, I did not realise what a huge problem SADS actually is. I drew out some statistics, which I will share with the Chamber: some 250 people die every single day in the UK as a consequence of sudden arrhythmic death syndrome or one of its counterparts, and some 270 schoolchildren die in British schools from SADS each year. The disease kills more people in Britain every year than lung cancer, breast cancer and AIDS combined; it is an absolutely huge issue, and it is fantastic that the OK Foundation has brought it to our attention in Parliament, because Oliver’s story is like that of any of the 60,000 SADS victims across the country each and every year.

The debate is crucial to raise awareness of the condition. We as parliamentarians have to date not done enough to address people’s concerns. I hope the fact that my right hon. Friend the shadow Health Secretary is in his place and will be responding for the Opposition demonstrates just how seriously we are taking the issue. I would like to place on record my thanks to the Leader of the Opposition for meeting campaigners in recent months, which is something that the Health Minister has refused to do so far.

I will briefly outline what sudden arrhythmic death syndrome is—or SADS, as it is known.

Children’s Cardiac Surgery (Glenfield)

Lord Garnier Excerpts

Monday 22nd October 2012 Westminster Hall

[Sir Edward Garnier (Harborough) (Con)]

I beg to move,

That this House has considered the e-petition from Adam Tansey relating to children’s cardiac surgery at the East Midlands Congenital Heart Centre at Glenfield, Leicester.

Mr Hollobone, I welcome you to our proceedings and thank the Backbench Business Committee for agreeing to the debate this afternoon. Parliament can respond to issues of public concern quickly. More than 100,000 names —I think that the total is about 103,000 at the last count—appear on the e-petition that I have referred to.

The new Secretary of State for Health has responded in short order to the facts presented to him, and I thank him for that. In a letter sent by him today to the various councils that referred the Glenfield decision to him, he says that the Independent Reconfiguration Panel will now conduct a full review of the decision by the Safe and Sustainable review. That is most certainly to be welcomed. However, he also says that the IRP will not consider the decision taken by his predecessor, my right hon. Friend the Member for South Cambridgeshire (Mr Lansley), to remove ECMO from Glenfield, as that decision was not taken by the joint committee of primary care trusts; I will say what ECMO means in a moment.

That last statement is illogical and certainly difficult to understand; we are surely entitled to assume that the previous Secretary of State made his decision on the basis of the recommendations from the Safe and Sustainable review. We need to find out, as an urgent priority, whether the new Secretary of State can reverse the decision on ECMO. As I am sure contributors to this debate will demonstrate, it would be sensible for him to do that and I look forward to receiving confirmation from my hon. Friend the Minister that that is going to happen. Cardiac services and an ECMO facility go hand in hand. We know that; I am sure that the Department for Health knows it, and I look forward to hearing in due course from my hon. Friend that she knows it, too.

I have had some intermittent contact over the years with the campaigners supporting the case for Glenfield’s ECMO and children’s cardiac units and I have visited the hospital on many occasions as the MP for Harborough, which is in south-east Leicestershire—most recently, when the additional facilities funded by the Thomas Cook travel company’s charitable foundation were formally opened in May this year. However, owing to the time and other constraints imposed on me as Her Majesty’s Solicitor-General, a post I held until last month, I have not been able to follow the development of the issues surrounding the Government’s reconfiguration of children’s heart services with as much attention to detail as I might have wished.

Now, what does ECMO mean? It stands for “extracorporeal membrane oxygenation”, and it is a highly technical, very clever and hugely successful medical means of recovering people who have both severe heart problems and severe respiratory problems. It might interest you to know, Mr Hollobone, that the only survivor of the house fire in Prestatyn at the weekend—the father of the household—is alive today only as a consequence of his being transported to the Glenfield ECMO unit, where he is under the treatment of Mr Giles Peek, one of the consultants there.

I am happy to report that, despite my absence from the battlefield, two other hon. Members from Leicestershire, my hon. Friend the Member for Loughborough (Nicky Morgan) and the hon. Member for Leicester West (Liz Kendall), have been at the forefront of the campaign to bring this matter to the attention of the Government and the wider public. That is not to say that my hon. Friends the Members for North West Leicestershire (Andrew Bridgen) and for Bosworth (David Tredinnick) have not played their part, nor that the Minister for the Armed Forces, my right hon. Friend the Member for South Leicestershire (Mr Robathan), and the Minister at the Department for International Development, my right hon. Friend the Member for Rutland and Melton (Mr Duncan)—colleagues who, unlike me, continue in Government—have not been working below the radar. Nor do I mean to suggest that my right hon. Friend the Member for Charnwood (Mr Dorrell), the Chairman of the Health Committee, has been a mere spectator—of course, he has not. All of us have been doing our best to ensure that the case for Glenfield is heard in the right quarters. That is also true of the right hon. Member for Leicester East (Keith Vaz) and the hon. Member for Leicester South (Jonathan Ashworth); despite their being respectively the Chairman of the Home Affairs Committee and an Opposition Whip, they have played their part in this campaign.

We have an abundance of parliamentary talent in Leicestershire, but if any praise is due, it is due to my hon. Friend the Member for Loughborough and the hon. Member for Leicester West, who have led the cross-party campaign—I stress that it is cross-party—to ensure that the case we are here to make has been, and continues to be, waged so effectively. The hon. Member for Leicester West is the constituency MP for Glenfield, but she is also the shadow Minister for Health, so she has a double reason for taking an interest in today’s proceedings. It goes without saying that she has been working very hard for her constituents, both human and institutional, in this regard, but she has been doing so in co-operation with my hon. Friend the Member for Loughborough, who is now a Government Whip; my departure from the Government has been more than compensated for by my hon. Friend’s promotion.

However, by convention and practice that means that my hon. Friend is no longer able to speak in Parliament, either here in Westminster Hall or in the main Chamber of the House of Commons. Nevertheless, she is in her place this afternoon and I know that she will continue, as we all will, to support vigorously the medical and ancillary staff at the Glenfield hospital and the patients and their families who benefit from the services provided by those doctors, nurses, technicians, administrators and the many others connected to that great hospital, some of whom are with us in Westminster Hall today.

My constituents Dr Sanjiv Nichani, the senior consultant paediatrician at the Glenfield hospital, who specialises in children’s heart care, and Mr Giles Peek, the director of the paediatric and adult ECMO programme and a cardiothoracic consultant surgeon, have travelled here today to hear the debate and to speak to the Minister afterwards, all being well.

[Patrick Mercer (Newark) (Con)]

May I express my support for the comments of my hon. and learned Friend? As you, Mr Hollobone, and he both know, Newark has all sorts of problems with health care at the moment. Glenfield hospital is crucial to my constituency. I particularly draw the attention of my hon. and learned Friend to the comments by Mrs Pamela Durney, who owes so much to this crucial hospital for her children’s health.

[Sir Edward Garnier]

I am grateful to my hon. Friend for that intervention. His support demonstrates that the issue is not only for Leicestershire, but one that affects patients from right across the east midlands and, I would suggest, from well beyond the east midlands.

Before my hon. Friend the Minister feels a little surrounded, may I thank her for being here to respond to the debate? I also congratulate her, although she must be bored of hearing congratulations, on this first step in what will be a long and successful ministerial career; I say that not as a question but as a statement of fact, and on that basis I am sure that we have won the case. I have no doubt that her response to this debate will act as an accelerant to her progress and provide great hope to those of us who want to see the Glenfield hospital’s ability to save lives continue.

Let me read out part of a letter from some members of staff at the Glenfield hospital:

“As members of the East Midlands Congenital Heart Centre team, we feel that we have a responsibility to our patients to ensure that we make clear our intentions with regards to the implementation of the recommendation of the safe and sustainable review. We are not in a position to leave our homes and families, to move to Birmingham to work. As a team of (predominantly) women, we are (predominantly) second wage earners, with husbands, children and homes. The toll of this review on both our work and home lives has been immense. It has created uncertainty and confusion, as well as intense anxiety. The repeated mantra of the review team that it will all be ok ‘with the help of the EMCHC team’ is meaningless in that we have not even been consulted. Unfortunately, we have been placed in a position where to refuse to relocate is openly criticized as being obstructive by the review. This is not the case. Our patients remain our priority within our working life, yet we have a responsibility to our families which, when push comes to shove, will over ride this.”

They go on:

“This letter is in no way representing a threat. It is an open expression of our concerns, over another assumption made by the review team, and which places us in a position where we are forced to choose between our patients and our families. We are a group of dedicated professionals, who have worked hard to achieve the excellence that we have done. Our patients deserve the best, and we fear that the recommendations will not give them that, and we will be unable to be there to support them.”

In my view, that letter speaks for them all—from doctors through to cleaners—and I hope that the Secretary of State will not forget the work that employees of the national health service do at the Glenfield unit when he comes to decide how best to proceed.

It is proposed that the number of cardiac centres in England be reduced from 11 to seven, and thus they will all be working at full capacity. Can the Minister ensure that in the event of a superbug outbreak, for example, as happened at the Belfast neonatal unit this year, or of a fire, as happened at Birmingham hospital in 2010 and in Leicester in 2011, or of any other catastrophic event in one of the cardiac units under consideration, that the remaining six will be able to cope with the pressure without endangering the lives of the critically ill children and babies in their care?

Glenfield already takes patients not just from Leicestershire, but from across the east midlands, as my hon. Friend the Member for Newark (Patrick Mercer) said. It also receives patients from Birmingham, Southampton, Northern Ireland and elsewhere in the United Kingdom—and even from Scandinavia and mainland Europe.

The Safe and Sustainable cardiac review for children in England has been under way for more than three and a half years. It proposes that the Glenfield unit be closed and its patients and neonatal and paediatric ECMO services be transferred to Birmingham. The Minister and the Secretary of State are, we now know, to revisit the medical and economic evidence that the review board has considered, but I look to them to make a different, better and more logical decision, based on the evidence that is there for all to see.

Four available options emerged from the review, and they were predicated not so much on the cost of providing children’s cardiac services—albeit that cost must play a significant part—as on their sustainability. I will not, for reasons of time, list the options or their components, but option A suggested that there should be seven surgical centres: at Glenfield, at Freeman hospital in Newcastle, at Alder Hey children’s hospital in Liverpool, at Birmingham children’s hospital, at Bristol royal hospital and at the two centres in London, each with four surgeons looking after a minimum of 400 children every year.

Following the public consultation between 1 March and 1 July this year, option A received the greatest support. The consultation was the largest ever public consultation within the national health service, with more than 75,000 respondents; nevertheless, that number is much smaller than the number of people who signed the e-petition that provoked this debate. Option A was supported by six of the 10 health regions in England. It is, at £22 million, the least expensive option—the next cheapest costs £44 million—and it has the added advantage of ensuring shorter travelling distances for families.

None of the four options is perfect or ideal, but the option that includes Glenfield satisfies many of the objective criteria that one would expect of a good solution—not least in respect of Glenfield’s nationally commissioned ECMO services. Given today’s letter from the Secretary of State, it is in that regard that our attention now needs to focus. Glenfield provides both cardiac and respiratory ECMO. Its national ECMO centre has been in operation since 1991, and it treats babies, children and adults from across the country and abroad.

ECMO is an invasive life-support system, which can be used on patients with severe respiratory or cardiac failure. It consists of removing blood from a patient, taking steps to prevent clots from forming in the blood, adding oxygen to the blood and pumping it artificially to support the lungs. There is an increased chance of survival of half as much again when a patient is treated in an ECMO centre rather than in a conventional intensive care unit. The Glenfield ECMO unit has the best results in the world, has more expertise and success than any other ECMO unit in the country and is the only such unit in the country to provide mobile ECMO. We have four national centres for ECMO, and the ideal scenario would be to maintain ECMO services in their current locations.

There is the fact that Glenfield’s ECMO unit was applauded by the national health service during the H1N1 crisis and that Glenfield’s ECMO survival rates are 20% higher than the United Kingdom average. Kenneth Palmer, director of the ECMO unit of the Karolinska university hospital in Stockholm and an international expert on ECMO treatment, wrote to my right hon. Friend the Member for South Cambridgeshire, the former Health Secretary, on 7 July, on learning about the proposal to shut the Glenfield unit:

“You will take over 20 years of experience from one of the world’s...best ECMO units and throw it away...to rebuild it in another place...You cannot move a unit, you can just destroy it and rebuild it with many years of decreasing survival rates and increasing morbidity”.

Mr Jim Fortenberry, paediatrician-in-chief of children’s health care in Atlanta, Georgia, also wrote to my right hon. Friend on 6 July:

“Glenfield has one of the finest ECMO programmes in the world and was the source of the recent CESAR trial, a landmark study that helped sort out the benefits of adult ECMO...The impact on care of attempting to move out this program in toto to another location would be devastating. ECMO is not merely the equipment, but the incredible collective expertise and institutional memory of its entire team”.

Glenfield has, over the years, built up a team of more than 80 ECMO specialists.

Dr Thomas Müller, ECMO co-ordinator at the university medical centre in Regensburg, Germany, wrote to my right hon. Friend on 9 July:

“Glenfield Hospital has won an excellent reputation for their expertise in paediatric and adult ECMO treatment and is deemed to be one of the world’s leading centres. The knowledge and experience of the staff in Glenfield probably is unmirrored in Europe and the US. To my knowledge, Glenfield treats the largest number of patients with severe cardiac and respiratory failure with ECMO worldwide...centres with less expertise certainly will experience a higher mortality. Therefore, in the interest of best patient care the decision to close down the most experienced centre of the UK is difficult to comprehend for somebody from abroad.”

Dr Leslie Hamilton, a cardiothoracic surgeon at the Freeman hospital in Newcastle, has also acknowledged that there is a risk in moving ECMO services from Glenfield.

Glenfield performs about 100 ECMO procedures a year, which accounts for 80% of the neonatal and paediatric activity in England and Wales. As I have mentioned, Glenfield also takes patients from other countries, including Scotland, Sweden, Finland and Ireland. The mortality rate at Glenfield is 20%, compared with 34% in the rest of the United Kingdom. Two additional surgeons have expressed an interest in going to work there. The centre is a popular place to work and can be made more “sustainable”—to use the jargon—with more surgeons and space.

In advancing the case for Glenfield, I do not need to denigrate the facilities and expertise of other hospitals. I see the right hon. Member for Newcastle upon Tyne East (Mr Brown) in the Chamber along with my hon. Friend the Member for Solihull (Lorely Burt), who no doubt represents the interests of the Birmingham children’s hospital. In advancing the case for the retention of the internationally acclaimed ECMO centre in Glenfield, I do not need to undermine the good work and dedication of cardiac and thoracic specialists elsewhere. I do not want to do that, and I would not have the time, even if I thought it a proper or sensible thing to do. It just so happens that Birmingham children’s hospital regularly refers patients to Glenfield. Why? Because unlike Birmingham, which conducts only cardiac ECMO, Glenfield does both cardiac and respiratory ECMO.

[Lorely Burt (Solihull) (LD)]

I fully endorse my hon. and learned Friend’s comments about Glenfield. Indeed, one of my youngest constituents, Yvie Beards, would probably not be here today were it not for Glenfield. However, does my hon. and learned Friend not agree that the type of expertise that we have in Leicester should be replicated in other parts of the United Kingdom? Although the Birmingham children’s hospital has one of the best child treatment centres, it could also contribute to that same level of care for children and others in the west midlands.

[Sir Edward Garnier]

I am sure that my hon. Friend is right, but we do not replicate what goes on in Glenfield by closing down Glenfield. If she and I are right about this, we need more Glenfields, not one fewer. We certainly do not need Glenfield itself to be closed.

Glenfield has this year opened a paediatric intensive care unit—a PICU—which will also become unviable as a result of losing paediatric cardiac surgery. Currently, 71% of those in the PICU are cardiac patients, so closing it down will no doubt affect the non-cardiac patients whom the unit treats. The loss of the ECMO service would also make the adult ECMO unit unviable. As of 18 October, option A is supported, on the e-petition, by about 103,000 signatories.

The Guardian, not necessarily a newspaper that a Conservative Member of Parliament leaps to quote from, pointed out on 28 April 2010:

“There has been a wealth of clinical evidence for many years that specialist clinical services, such as stroke, trauma and heart surgery, should be concentrated in fewer centres… Survival and recovery rates would improve markedly with many lives saved.”

The ECMO unit at Glenfield works: it helps children survive and, as we just learned from the Prestatyn case, it helps adults survive. The medical evidence shows that the ECMO unit works, and now it is up to the Secretary of State to understand that and let both the unit and the children it treats survive.

--- Later in debate ---

[David Tredinnick (Bosworth) (Con)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I offer many congratulations to my hon. and learned Friend the Member for Harborough (Sir Edward Garnier), who very deservedly received a knighthood recently. I remind him that that is of course a tradition in his constituency, as his predecessor was also knighted. I served with Sir John Farr in my first Parliament, and he did so much for hosiery and knitwear in his constituency. I welcome my hon. Friend the Minister to the Front Bench. It is very nice to see her there.

It is clear from remarks that hon. Members have made that there is universal and cross-party support for retaining children’s services at Glenfield. One of the first decisions of the new Secretary of State for Health was to call the matter that we are debating in for review. That bodes well, because my right hon. Friend did so well with the Olympics that I believe he will do just as well as Secretary of State for Health. His decision shows his light touch. The fact that we now have a second chance to consider the issues, and the welcome arrival of a letter today, saying that the Independent Reconfiguration Panel will commence a full review and report not later than 28 February, is a huge relief for the county. My hon. Friend the Minister has already intervened to point out that she cannot second-guess what it will say, but the point of today’s debate is to give Leicestershire Members on both sides of the House an opportunity to show how concerned we are about the decision and to make some points about it.

I shall not repeat the points made by my hon. Friend the Member for Harborough or the hon. Member for Leicester South (Jonathan Ashworth), who engagingly described my hon. Friend as learned; I think, Mr Hollobone, that we are not allowed to do that any more. Did not the reforms of the House say that we could not call—

[Sir Edward Garnier]

You can make an exception.

[David Tredinnick]

My hon. and learned Friend says I can make an exception for him, and I am delighted to do that.

The first point I want to make is that there is real concern that we are working on faulty statistics. The data used to make the decision were based on 2006-07. We need only consider the recent publication of the census in London to see the huge increase that there has been in population. There are shifting populations, and there is concern that the analysis is fundamentally flawed. It is not only my right hon. Friend the Secretary of State for Health who has had to consider flawed data recently. What about the west coast main line, whereby we found we were operating with completely inaccurate information? The right hon. Member for Newcastle upon Tyne East (Mr Brown) nods his head. This can happen in Departments, and we must take note of it.

My hon. and learned Friend the Member for Harborough and the hon. Member for Leicester South have addressed the issue of the ECMO link. To most reasonable people, it seems absurd that the two decisions will not be linked. I am sure that there are legal arguments, but somehow we must get a sensible decision so that both issues can be considered together.

The next point concerns the site of Glenfield. Glenfield is a hugely popular hospital not just with patients, but with surgeons. From, one might say, a feng shui point of view, it is on top of a hill outside the city, and it has a good, clean, clear energy. That is why everybody likes working there: it is nicer for everybody than the Birmingham site, as is proven, I would suggest, by a survey showing that only 2% of the staff in Glenfield want to move to Birmingham. It is not just BBC current affairs programmes that are jumpy about moving out of their current locations, as there is a real problem with the decision to move from Glenfield to Birmingham, as the hon. Member for Leicester South said. The body of knowledge built up over 20 years will dissipate, because many of the people who work at Glenfield simply will not move.

My next point involves the increased pressure on Birmingham, which has been referred to. Can Birmingham deal with it? Somewhere in the briefing papers is a point about Bristol. What happens if something goes wrong at Bristol and patients are moved around? My hon. and learned Friend the Member for Harborough made the point about the terrible tragedy in Wales, during which patients have been brought to Glenfield. Is it wise to concentrate all the resources in the midlands in one centre? I wonder whether it is.

--- Later in debate ---

[Sir Edward Garnier]

I thank everyone who has contributed to the debate—whether the Minister, the Opposition Front Bencher or Back Benchers. It has been thoroughly useful, informed and informative, and I am grateful to everyone who has assisted in the process.

On the process, I suspect that my hon. Friend the Minister was tiptoeing around the issue, not wishing to trespass across a difficult line, but it is important not to confuse process with what we are sent here to do as Members of Parliament and as Ministers, which is not to confuse the substance with the means by which we make decisions. Our constituents expect us, as elected politicians, to come here and speak for them and say things that may be disobliging to those who hold the levers of power—and that is what we have done.

I know that the Minister is concerned—of course, she should be—that anything she says might be taken as ammunition that would fuel someone’s thoughts about a judicial review of a decision made by a previous Secretary of State, and I do not want to push her in any direction that might cause her that problem. None the less, we all know what lies behind her careful words. At least I do—I am sure that many others do as well—and I am entitled, as she is not, to rip away that veil and get to the heart of this question: what is to happen to the ECMO services, both adult and children’s, at the Glenfield centre, and what is to happen to the cardiac services for children at Glenfield? As has been agreed across the Chamber this afternoon, those are inextricably linked questions.

The House does itself no great service if it shilly-shallies around process and avoids the question. As Members of Parliament, we must ensure that the question is put. The question this afternoon has been put, and the Minister has done her best to answer it, but the message that she must take back to her Department is that we are not as fascinated as some of her departmental lawyers might be by who made which decision and whether or not the joint committee of PCTs is an independent reviewing body.

The Secretary of State has the levers of power in this question and he must pull them—he must exercise them—and make a decision. That is what he is paid to do, what he was appointed by my right hon. Friend the Prime Minister to do and what he was elected to Parliament to do. I am sure that the Minister will give him every assistance in reaching what is the inevitable answer to the questions posed this afternoon—namely, that the Glenfield ECMO unit, for children and adults, and the Glenfield cardiac services unit should remain open.

I do not care who made the decision or how the dainty route was created to get to it. We all know that the current decision is wrong and needs to be dealt with. The Minister, please, will go back to her Department and inform the Secretary of State that Parliament thinks that that decision is wrong and that Parliament requires the Government, through the Department, to change it. How they do that is up to them, but they must do it.

I thank the Minister for her patience in listening to us. I thank her for dealing with a difficult and, as she rightly says, emotionally charged subject. None the less, we have to set aside the emotion and the personal and heart-rending stories, make the right decision and just get on with it. I look forward to the Secretary of State writing us another letter, in a very short time, in which he adds to the letter of today’s date a decision to review the ECMO matter as well, because, as we all know, it is not possible to separate the two, and it is not possible to separate us, as elected representatives for our constituents, from this issue. We will stick to it like a barnacle until we are satisfied that the matter has been properly resolved. I look forward to having further such discussions with my hon. Friend the Minister in the very near future, but I thank her most sincerely for her presence here today and her contribution.

Question put and agreed to.

Resolved,

That this House has considered the e-petition from Adam Tansey relating to children’s cardiac surgery at the East Midlands Congenital Heart Centre at Glenfield, Leicester.