Children’s Cardiac Surgery (Glenfield)

Debate between Stuart Andrew and Martin Vickers

Monday 22nd October 2012 Westminster Hall

[Martin Vickers (Cleethorpes) (Con)]

It is a pleasure once again to take part in a debate under your chairmanship, Mr Hollobone. I join other hon. Members in congratulating my hon. and learned Friend the Member for Harborough (Sir Edward Garnier) on securing the debate.

I feel like something of an intruder, coming from the remote parts of Lincolnshire to this east midlands event. I rise to speak because many of my constituents’ children and grandchildren have received treatment at Glenfield and Leeds, and I have campaigned with my hon. Friend the Member for Pudsey (Stuart Andrew) for the retention of the Leeds unit. We have centres of excellence and we want to retain them. My constituency is at the end of the line and somewhat remote, so the geography of where people receive life-or-death treatment is of particular concern. We joined the campaign for the Leeds unit and heard from parents how the distance to the life-saving unit has made a big difference. Cleethorpes is 80 miles from Leeds and 90 miles from Leicester.

The alternatives suggested to my constituents—in Newcastle—have been a significant factor in the opposition to the proposed changes. We already feel remote and out of it. I do not want to be frivolous, but if, for example, some of my constituents were involved in an accident, Humberside police would attend and summon an ambulance from the east midlands, which would then take them to Grimsby hospital, which is administered by the Northern Lincolnshire and Goole Hospitals NHS Foundation Trust. All these factors give people a sense of unease, and a sense that they are at the end of the line and do not matter. It is essential that we ensure that services are as close as possible to the people.

Parents will go to the ends of the earth to take their children to emergency treatment, but as a national health service we have to ensure that services are, wherever possible, as close as possible to the centres of population. We need to bear in mind the need to have centres of excellence, which, as the clinicians constantly tell us, means more and more concentration, but remoteness will mean that these proposals are unlikely to be achieved.

[Stuart Andrew (Pudsey) (Con)]

My hon. Friend is making an important point. The Safe and Sustainable review found, from its own independent advice, that patients in his constituency would not travel to the units that would be kept open under the proposals.

[Martin Vickers]

My hon. Friend is right. I think it was proposed that the likely number of operations taking place in Newcastle would be 403. That will not be achieved, because people in Cleethorpes and northern Lincolnshire will not travel to Newcastle; they will look for alternatives. With doubts being cast on the centre at Birmingham, inevitably, if Leeds and Glenfield closed, people would gravitate south rather than towards Newcastle.

We have heard expressions of concern about the process of consultation, and there is no doubt that the view that the consultation was flawed is widespread. Indeed, my hon. Friend the Member for Pudsey drew attention to that in an Adjournment debate a few weeks ago. I appreciate that the Minister said, in an intervention, that the review was by clinicians. The problem is that clinicians always tend to want to gather together in more and bigger centres of excellence, and our constituents want as local a service as possible.

I hope that when the Minister and the Secretary of State make their decision they will consider other aspects. The expertise of the professionals is important, but access to services is also important. The last thing that people want is a decision that comes from a review by people they do not know and about whom they are doubtful—expert opinion—at the best of times. They want the Secretary of State to weigh up all the factors, not just the expertise. Parents and grandparents of children who have received treatment from these units know, from personal experience, the care and attention that they provide, and they fear being shunted away.

We have centres of excellence. Please, Minister, do not rubber stamp a review that wants to close them. Consider, first of all, the children who are treated by these centres.

health

Debate between Stuart Andrew and Martin Vickers

Tuesday 18th September 2012 Commons Chamber

[Stuart Andrew]

I am grateful for that intervention, which brings me on to exactly that point. The review’s decision said that 25% of Leeds, Wakefield, Doncaster and Sheffield patients would go to Newcastle, when its own evidence said that they simply would not. Funnily enough, if 25% of those patients go to Newcastle, guess what? Suddenly, 403 patients a year will have surgical operations in Newcastle, which is just three more than the magic figure of 400. I do not believe that that 25% will exist, so Newcastle will miss the target of 400 operations, which is a key plank of the whole review.

We have heard about how public opinion has been discounted. A petition signed by more than 600,000 people was brought down to Downing street. That is an enormous number for one region, yet the review counted it as just one response. On the other hand, 22,000 text messages received in support of Birmingham were counted as 22,000 separate responses, which is blatantly unfair.

One of the most important issues is the co-location of services. What has impressed me about the Leeds unit is that it is part of the Leeds children’s hospital. All other surgeons get there within minutes, if needed. We are asking our patients in our constituencies to go to Newcastle, where all other services are some 3 miles away from the heart surgery unit. That is simply not acceptable and goes against the advice of the key recommendation of the Bristol inquiry, which was backed by the British Congenital Cardiac Association. The inquiry said:

“For these services at each centre to remain sustainable in the long term, co-location of key clinical services on one site is essential.”

It is important that we do not forget that.

The fact is that, allowing for patient choice and without the flow of patients from the populous areas of Yorkshire, as evidenced by the PricewaterhouseCoopers research, Newcastle will not reach the target of 400 surgical procedures. In 2010-11, Leeds delivered 336 procedures against Newcastle’s 271.

The impact assessment also showed that the options that included Leeds would have fewer negative impacts and that option B, which included Newcastle, would be particularly damaging for paediatric intensive care in Yorkshire and Humber.

It is also important to ask why Birmingham was chosen because of its density of population and Leeds was not, given the fact that we have a high south Asian population who, statistically, are more likely to need the service. As we have said time and again, doctors should go where the patients are, not the other way around.

Sheffield parents whom I have met at the unit travel three times a day to visit their children in hospital, because they have other children at home. We have to think about the impact this has on families.

[Martin Vickers (Cleethorpes) (Con)]

I congratulate my hon. Friend on his work on this issue. His point about distance is particularly relevant to my constituency. Cleethorpes is about 85 miles from Leeds and the parents will not travel to Newcastle, so it will not reach that figure of 403.

[Stuart Andrew]

I am grateful to my hon. Friend for the support that he has given to the campaign by meeting his own constituents who, he is right to say, will not travel to Newcastle. His comments further highlight the ludicrous nature of the decision.

I have presented the problem, so what is the solution? I recognise that the review is independent of Government, but we have to tackle the problem—it will not go away, because we as Yorkshire, Lincolnshire and Humberside MPs will not let it. Our view is that the review could happily be implemented elsewhere, that both Leeds and Newcastle should be kept open and that a decision on their future should be delayed until April 2014. That would provide an opportunity for patients and parents who require the services to exercise their constitutional right to patient choice and to determine which centre they wish to access. By the end of that period, each centre would have to demonstrate that they were fully compliant with all the standards set by the Safe and Sustainable review.

This solution would amount to only a one-year pause. Given that legal proceedings are likely to take place, there will be a one-year pause in any case. The reconfiguration of all children’s heart surgery centres in England is not due to commence until April 2014 and a decision taken at that time on Leeds and Newcastle could be implemented in 2015. The definition of a centre that delivers a sustainable service is that it should have a minimum of four surgeons, so if, after the one-year pause, commissioners did not think that the Newcastle unit had a sufficient work load, the Leeds unit could explore how it could provide support in conjunction with Newcastle.

If either of the centres did not meet the standards, it would, frankly, let itself down. This solution gives them the opportunity to provide the services that families are so desperate to keep. There are many benefits to the solution: it would avoid the risk of a costly judicial action from supporters of either unit, which could sink the review in its entirety; it would give Leeds and Newcastle the opportunity to demonstrate their compliance with the safe and sustainable standards, which is what we all want; it would allow the less controversial decisions made by the JCPCT to proceed elsewhere in the country; and it would show, frankly, that the Government are listening to the concerns of the 600,000 people who signed our petition, and I am sure that the public would respond accordingly.

I know that this is not an easy decision, but there is a great deal of concern and anxiety in our region. I hope that the Government will not just give us the line that this is a review independent of Government, but acknowledge that there are serious concerns and great anxiety among our patients and families, and that it is time to look at the issue in detail, to listen and to act.