Health: Congenital Heart Disease

Baroness Watkins of Tavistock Excerpts

Thursday 20th July 2017 Lords Chamber

[Baroness Watkins of Tavistock (CB)]

My Lords, I thank my noble friend Lady Boothroyd for calling this debate and I want to add some of my own thoughts to those that have largely been expressed by other noble Lords.

Currently in London, paediatric heart disease services are provided at Great Ormond Street, Guy’s and the Royal Brompton. The proposal is to reduce this provision to two centres. What evidence is there that this approach will improve services for patients? There are, I understand, 15 specialist paediatric intensive care beds at the Brompton. The ITU service is staffed by highly skilled and trained doctors, nurses and other clinical team members. Such staff are expensive to train and often very difficult to retain. What reassurance can the Minister give that all these staff will be given opportunities to continue working in their chosen field at their current grade in London or elsewhere in the NHS? Will TUPE apply? There must surely be a risk that these staff, unless given suitable employment choices within the NHS, will leave and possibly, as my noble friend Lady Masham stated, go to work overseas—where, make no mistake, they will be welcomed not only with open arms but with generous employment packages.

I understand that the 15 ITU children’s beds are key to providing training opportunities for student nurses from three different universities. Can the Minister assure the House that, if these beds are not fully re-provided, similar clinical placements will be found to prepare the next generation of nurses with paediatric intensive care skills?

In London recently there has been a range of large-scale emergency challenges due both to the two recent terrorist attacks and the tragic fire at Grenfell Tower. The health service and hospitals generally quickly responded, with both adult and paediatric ITU beds being utilised to their maximum capacity. While I appreciate that the ITU beds at the Brompton are predominantly used for children’s cardiac work, is it possible that the reduction of 15 paediatric ITU beds in what is, effectively, west London may affect the ability to provide sufficient services in any future large-scale emergency?

I understand that the decision to keep four trauma centres around London was partly provided on accessibility. Will the Minister seriously consider the possible consequences of reducing the paediatric coronary service ITU beds from three to two; and is it simply a considered response to the chronic financial challenges in the NHS rather than an attempt to enhance potential clinical outcomes? I more than many in this House want to see new investment in child and adolescent mental health services—a manifesto commitment—but is the NHS envelope simply too small a proportion of GDP, pushing NHS policymakers to close some services in order to develop others?

Finally, it has been argued by other noble Lords that research will suffer at the Brompton and its academic partners as a result of this proposal. I ask the Minister, is this the time, with Brexit on the horizon, to adversely affect research in a centre of international excellence and to risk losing not only expert clinical doctors and nurses but also research teams?

I sincerely trust that the issues raised in this House will be carefully considered, not only by the Minister this afternoon but also by those policymakers who are considering how best to provide the excellent-quality services for patients with congenital heart disease currently provided at the Royal Brompton Hospital.