Glenfield Hospital Children’s Heart Surgery Unit

Debate between Lord Garnier and Liz Kendall

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.