Children’s Cardiac Surgery (Glenfield)

Andrew Bridgen Excerpts

Monday 22nd October 2012 Westminster Hall

[Andrew Bridgen (North West Leicestershire) (Con)]

It is a great pleasure to serve under your chairmanship, Mr Hollobone. I welcome my hon. Friend the Minister to her post and congratulate my hon. and learned Friend the Member for Harborough (Sir Edward Garnier) on securing this important debate.

As the Member for North West Leicestershire, I speak for a constituency roughly equidistant, in distance and travel time, from the Glenfield site and the Birmingham children’s hospital site. For my constituents, there is nothing to choose between the two, so I have a position of relative impartiality. I am interested in patient outcomes.

I recently toured the congenital heart centre at Glenfield, and two main concerns from the report were raised with me. The first was the issue of capacity and demand, which was raised by the hon. Member for Leicester South (Jonathan Ashworth) and my hon. Friend the Member for Bosworth (David Tredinnick). The figures given by the Department of Health were queried. It has been calculated that Birmingham children’s hospital will be expected to deal with 611 cases a year. However, clinical teams have suggested that it could be 900 to 1,000 procedures a year. Birmingham children’s hospital, having done its own modelling, expects the number of procedures to be more than 900.

I understand that senior commissioners acknowledge that the number is likely to be significantly higher than the figure of 611 used in the review, as does Sir Roger Boyle, the recently retired cardiac tsar, who initiated the project. The calculations demonstrating that the closure was a safe and sustainable option for the midlands, which considered travel, access, quality, deliverability, sustainability and affordability, were based on 611 operations, not 900 or 1,000. Doctors at Glenfield doubt very much that Birmingham children’s hospital has the capacity to handle that volume of work. In addition, Birmingham children’s hospital has stated that it wishes to move to a new site within 10 years, as it has already reached the limit of what can be achieved in the space that it has. Based on that, I would like the points that I have raised to be addressed to ensure that the Safe and Sustainable exercise was carried out using the correct data.

I turn to extracorporeal membrane oxygenation, or ECMO, a life support service currently delivered at Glenfield. There is a strong argument that the value of the service has not been fully appreciated throughout the review. Glenfield pioneered ECMO treatment in the UK and delivers education, training and clinical support to other ECMO centres in the UK and abroad. Survival after ECMO treatment in the Glenfield unit is far more likely than in other UK and international centres—that is, more children survive.

Several concerns have been raised with me about the Safe and Sustainable process for assessing the risks and practicalities of moving the service. I understand that only two experts were consulted about moving ECMO, and that the Swedish ECMO expert Kenneth Palmer, of the Karolinska Institute, has publicly expressed his anger at how his views have been used to justify the move from Glenfield, and has withdrawn his support for the process. Another issue is how a Sea King helicopter carrying a patient might land in central Birmingham. Glenfield can handle that, because it designed a system to accommodate it. Although the use of a Sea King helicopter is rare, we have heard that when they are used, as in the recent fire in Wales, they are life-savers. I would welcome a further review of the matter.

I remain concerned that Birmingham children’s hospital will not see ECMO as a strategic priority and might contemplate splitting the service among other providers, which would defeat the principles of the Safe and Sustainable review and put at risk the world-class results that we are achieving. The review’s aim is to concentrate expertise and deliver more positive outcomes. However, there are no plans for any other ECMO provider, including Birmingham children’s hospital, to use what my hon. and learned Friend the Member for Harborough termed the mobile retrieval service. That goes against the principle of the whole review.

The mobile retrieval service that Glenfield provides is a fundamental aspect of the service, and it partly explains why Glenfield produces so many positive outcomes. Its team travel by ambulance to the hospital where the sick child is located, taking all the necessary kit with them to start ECMO treatment. ECMO is then started on site and continued in the ambulance on the way back to Glenfield, ensuring that children receive the treatment as soon as possible at a time when their life expectancy without treatment might be measured in hours rather than days, and avoiding a much riskier ambulance journey on a simple ventilator. If that aspect of the service is not taken up by others in Glenfield’s absence, there is a danger that fewer children will survive horrific illnesses.

Will the Minister clarify the level of scrutiny of the results achieved at Glenfield and Birmingham children’s hospital? Since the decision was made, the unit has stated that it invited various members of the Safe and Sustainable review to Glenfield to show them the results of the past 10 years, which, it believes, demonstrate the success of its service. It has no record of that data being shared previously, and I would welcome clarification on what data were looked at during the initial review process.

A significant concern, highlighted by my hon. and learned Friend the Member for Harborough and the hon. Member for Leicester South, is the fact that it cannot be assumed that the staff who deliver the service at Glenfield will relocate to Birmingham. Many live east of Leicester and will find the commute to Birmingham unviable. I understand from Glenfield hospital’s own surveys that a number of staff have indicated that they are unwilling to move to the new unit.

There is also concern regarding the air of uncertainty that surrounds these units. Once a unit is earmarked for closure, the most able and gifted personnel quickly find jobs in other areas. That puts the process under great strain and leads to a rise in mortality rates. I hope the Minister gets on with this review as quickly as possible, so that we have a rapid resolution and can provide some reassurance to staff to ensure that we keep the service at its superb, world-class level.

We need to ensure that the conclusions of the Safe and Sustainable review are safe and sustainable—not only for the remaining structure of the NHS, but for my constituents in North West Leicestershire and all constituents in Leicester, Leicestershire, the east midlands and the midlands as a whole. I hope the Minister will take account of that.