Children's Heart Surgery (Leeds)

Alec Shelbrooke Excerpts

Thursday 3rd March 2011 Commons Chamber

[Stuart Andrew]

I entirely agree. I was about to deal with that point. I believe that there is a very strong case for Leeds. It has the capacity to expand, and is within a two-hour drive for nearly 14 million people. It has one of the highest population coverages among all the units in England, with 5.5 million people in the Yorkshire and Humber region. Leeds is, of course, centrally located in the north of England, and can accommodate patients from outside the current catchment area.

[Alec Shelbrooke (Elmet and Rothwell) (Con)]

I congratulate my hon. Friend on securing a debate on an issue that is vital to the people of our city. Leeds is not only central, but has been described as the motorway city. It has excellent rail links as well, which makes speedy access to the hospital possible.

[Stuart Andrew]

I am beginning to think that some Members have already seen my speech. I am getting ahead of myself. We have the M1, the A1, the M62 and excellent rail links, which make Leeds very accessible. The Leeds Hospitals NHS Trust has centralised children’s services, which I think meets the requirements of the Department of Health’s critical interdependency report. On 18 February the British Congenital Cardiac Association, which is a leading support organisation of the safe and sustainable review, released a statement saying:

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

Leeds General Infirmary is at the forefront of work on inherited cardiac conditions, and has an excellent record of providing safe, high-quality children’s heart surgery. The Yorkshire region has significantly higher birth rates than other parts of the country, particularly the north-east, and there is no doubt that demand will increase.

The review is informed by the overall opinion that a reduction in the number of centres is the best way in which to secure a safe and sustainable future service. It is guided by four principles, and I believe Leeds more than meets their requirements. The first is quality. The paediatric cardiac service at Leeds General Infirmary extends from pre-natal diagnosis to the treatment of congenital heart disease in adults, with excellent clinical outcomes. It has high standards and a personal service, and, as I have said, is located very centrally.

During the assessment process, Sir Ian Kennedy and his assessment panel visited every children’s heart surgery unit in England. They produced individual assessment reports on each of the units two weeks before the presentation meeting at the joint committee of primary care trusts on 16 February. At the meeting, the four reconfiguration options were presented. They were based on a number of factors contained in the panel’s assessment reports. However, I understand that there are significant factual inaccuracies in Sir Ian Kennedy’s report on the Leeds unit, and that its representatives were given no opportunity during the process to comment or request amendments of the factual inaccuracies before decisions were made about the configuration of the options for consultation.

At a meeting of the all-party parliamentary group on heart disease on 9 February, when asked when units would be able to challenge and amend inaccuracies in their reports, Jeremy Glyde, the programme director of the safe and sustainable review, said that that could be done during the consultation process.

The reports that the reconfigurations were based on contain fundamental inaccuracies, but they can be challenged only during the consultation period to decide which option is preferred. For Leeds, these inaccuracies include the following. Sir Ian Kennedy’s report documented that Leeds has no transition nurse and separate paediatric intensive care unit; neither point is factually accurate, to the extent that his assessment panel actually met, and talked to, one of the unit’s three transition nurses. The joint committee of primary care trusts advised at its meeting on 16 February that Leeds had stated that it could not do more than 600 operations. Again, that is factually incorrect— Leeds was never asked—but it was stated as the reason why two of the 14 options that were considered were discounted. The commissioners have acknowledged that this was an assumption and not based on what Leeds had said. In the pre-consultation business case for Leeds, start-up costs were reported as £2 million. That figure was not provided by Leeds, and is not representative of the accurate costs provided to the safe and sustainable review panel.

--- Later in debate ---

[Stuart Andrew]

I absolutely agree. For hearts, time is of the essence. We need to be sure that people can get where they need to be quickly. I met my hon. Friend’s constituent the other day, and she spoke very powerfully and emotionally about what that meant in her case. I cannot imagine how families in these situations must feel. It is imperative that there is a facility close by.

Returning to the reviews, there are also inconsistencies in the application of some of the principles. So, for example, Liverpool and Birmingham are in all the options because of density of population and access for patients, but the same does not seem to apply to the Leeds case. That is odd and I do not know why the Liverpool and Birmingham cases are different.

Not enough emphasis has been given to co-location. The facility at Leeds general infirmary is wonderful now—I am given to understand that it is the second largest children’s service in the whole country—so taking away its heart unit and the expertise that has been gathered there over the years is strange. This is not just about children’s heart services, because the process has failed to seek views from adult congenital patients. The doctors who operate on the children also operate on the adults and it appears obvious that wherever the children’s heart services go, so, too, will the services for adults. Will they have had an opportunity to be consulted on what was going to happen to those services? This is about a much wider point than just children’s services.

[Alec Shelbrooke]

My hon. Friend may be coming to this issue, but could he comment on the fact, which has been put forward every now and again, that Newcastle is favoured because its facility performs adult heart transplants? We recognise that surgeons have equal skills and just because somewhere does the adult heart transplants, it does not necessarily mean that we should move the children’s heart surgery to that department.

[Stuart Andrew]

That is a very valid point and I shall shortly discuss something that was said the other day because it will comment on that.

I shall conclude now because I know that a couple of other Members have expressed an interest in speaking in this debate. I understand that this process is going to be difficult and that there is a need for a review. Severe problems have been experienced in parts of the country and it is right that a clinically led decision is made, but I want that decision to be made on the basis of facts that matter to local people and that are accurate. As I have mentioned, there are real problems with the assessment and the options that have been mentioned. Emotions will of course run high, because this is a very emotive subject. It is incredibly moving to listen to the families I have been speaking to since this matter first arose. They describe how their children and their babies were so close to death but how, thanks to the expertise that was provided at this location, which they were able to reach, their children are at least here and receiving the wonderful care that is provided, although they may be poorly.

There is a case to be made for the facility at Leeds in terms of geography, population and access. We like to tick boxes in this country and everything is ticked in this case for Leeds. I would be grateful if the process could be examined. Some powerful comments were made and cases were mentioned at a meeting held with parents and clinicians here on Tuesday. They are desperate for this unit to remain open. As someone said at that meeting, the doctors should move where the patients are; it should not be the other way round.