Congenital Cardiac Services for Children

David Davis Excerpts

Thursday 23rd June 2011 Commons Chamber

[The Minister of State, Department of Health (Mr Simon Burns)]

I congratulate my hon. Friend the Member for Pudsey (Stuart Andrew) on securing this debate on the review of children’s heart surgery services. He has a strong record of campaigning on this issue and of bringing the concerns of his constituents to the attention of the House. I also congratulate him and the other hon. Members on the motion they tabled. The Government and I wholeheartedly support its contents, and I urge other hon. Members to do so as well.

I should also like to take this opportunity to pay tribute to the dedicated NHS staff who work in children’s heart services in my hon. Friend’s constituency and across the country. They do a tremendous job, for which we are all incredibly grateful, more often than not in complex and difficult circumstances.

I should like to confirm that the review is totally independent of the Government, and that it is clinically led. It is not driven by me, by other Ministers or by the Department of Health. It is therefore not appropriate for me to comment on the specific hospitals consulted during process. I do not wish to act, or to be seen to act, in a way that could influence or prejudice the process that is going on. As many hon. Members have said, this is a highly emotive issue, particularly for those whose children’s lives have been saved by the services under review. It is worth reminding ourselves why the review was conceived and planned and is now being carried out.

This is not a new issue. The provision of children’s heart surgery has been a cause for concern since the Bristol Royal infirmary inquiry in the late 1990s. Understandably, there has been considerable pressure from national parents groups and professionals to ensure that children receive the best treatment, and the sole purpose of the Safe and Sustainable review is to ensure that children with congenital heart problems receive the best possible care now and long into the future. To do that, we must be certain that the centres in which surgery takes place are as good as they can be.

[Mr David Davis (Haltemprice and Howden) (Con)]

The Minister will not be surprised to hear that my constituents, like all the others in Yorkshire, are in favour of Leeds, but I do not want to draw him on that. I would like him to help us in our argument by telling us what the clinical outcomes for Leeds are and how they compare with other centres. In particular, will he confirm that they are all safe?

[Mr Burns]

I am grateful to my right hon. Friend for that intervention. With regard to Leeds teaching hospital, he will know that this is a complex issue. There are 36 different surgical procedures listed on the central cardiac audit database, but the three most relevant ones in the context of his question are those that deal with atrioventricular septal defect, arterial switch and Fallot’s tetralogy. Over the past six years, 304 operations have taken place involving those three specialties. Sadly, the number of patients who died within 30 days was 12, and 18 died within one year. The results of surgery in all units are good, with no significant divergence. The issue, however, is the future. We need to prepare for units that can deal with these highly complex procedures and the intense technology needed, and provide the qualified doctors and nurses involved, in order to keep up with professional and public expectations of the high quality of care required. This is not so much about today’s figures as about how we meet the challenges of the future to provide the finest and safest possible care in this deeply complex area of medical treatment.

The consensus among professional associations is that there should be no fewer than four congenital surgeons in a centre, each performing between 100 and 125 procedures every year, for a centre to be optimally staffed. Over the past few years, the outcomes for the services have remained good, as the figures that I have just given to my right hon. Friend illustrate, but there have been several warning signs that the current arrangements are fragile. For many years, professionals and national children’s charities, including the Children’s Heart Federation and the British Heart Foundation, have urged the NHS to review services for children with congenital heart disease. They have consistently raised serious concerns about the risks posed by the unsustainable and sub-optimal nature of smaller surgical centres.

Many of the 150 types of operation undertaken by these dedicated teams are among the most complex, challenging and technically demanding areas of surgery. Success requires intricate surgery on hearts often no bigger than a walnut, coupled with finely balanced judgments drawn from a combination of advancing science, personal experience and compassion. It involves a range of highly trained individual team members—before, during and after the operation.

The risks posed by the complex nature of heart surgery include not just possible death after surgery, but lifelong complications such as brain damage and other disabilities. The judgments of any expert medical team caring for a particular child therefore have a direct and long-lasting impact not only the future of each vulnerable child, but on that of their families.

There is also the issue of recruitment. The fact is that smaller centres have problems with recruiting and retaining the very best surgeons. There is a risk that those working in smaller centres will find themselves working in isolation and in units that are not as up-to-date with techniques and clinical practice as the larger ones are.

Contaminated Blood and Blood Products

David Davis Excerpts

Thursday 14th October 2010 Commons Chamber

[Mr Clarke]

I am sorry, I do not have time.

My constituent also talked about the increased premium he faced in getting travel insurance. People are clearly being penalised again and again because they had the misfortune to find themselves with this condition of haemophilia and then found, as they approached the national health service, that their condition was made unacceptably worse.

I want to thank the organisations that have helped. With particular reference to Scotland, I want to thank Mr Philip Nolan, who spent several hours with my constituent and me, and who, it seems to me, has been in London almost every week for years, preaching to us the necessity to act.

My constituent referred yesterday to the position in Northern Ireland. I do not want to open up yet another party political debate, but the truth of the matter is that even with its economic difficulties, Ireland—if I said Northern Ireland yesterday, I should have said Ireland—has not abandoned its scheme.

[Mr David Davis (Haltemprice and Howden) (Con)]

rose—

[Mr Clarke]

I am sorry, but I do not have enough time to give way.

If the scheme means getting earlier acceptance on to the waiting list and getting problems recognised, and if our constituents should not be doubly penalised for something that is not their fault, I am with my constituent in saying that justice delayed is justice denied—and we have denied justice for far too long. Today provides us with an opportunity to put that right.

--- Later in debate ---

[Jenny Willott]

The hon. Gentleman is correct. This debate on the Floor of the House is something for which many of those affected have called for a number of years. For them, it is important that that has been recognised and that Ministers are now listening to Members of all parties expressing their views.

[Mr David Davis]

Like the hon. Lady, I would have liked the debate to be less partisan than it has been so far. Her example highlights what a tragedy this has been and what an injustice has been committed. Although we are in the midst of a massive financial crisis, we should all recognise that tragedies and injustices like this deserve priority in spending terms over everything else.

[Jenny Willott]

I agree with the right hon. Gentleman. I am disappointed that, as was announced in the statement earlier today, not all the recommendations will be reviewed.