Leeds Children’s Heart Surgery Unit

Fabian Hamilton Excerpts

Tuesday 30th October 2012 Westminster Hall

[Stuart Andrew]

The answer is that I do not know. I have not been given any assurances that that will happen, which again highlights the crucial problem with the decision: we will be subjecting our constituents to a lesser service.

I spoke to another family at the unit. Libby was diagnosed at 20 weeks with complex heart problems, and her mum was referred for the rest of her antenatal care to LGI, where the baby was delivered; that again demonstrates the crucial co-location of services. It was clear that the daughter needed treatment immediately after birth, and at six days old she had her first of many operations. As she has complex medical needs, she has also needed support from the paediatric neurology and renal teams, and all those services are under one roof, which provides first-class care. My final example is of a child who had an operation in Leeds at 18 months. All the care was then delivered in Barnsley by doctors from Leeds. Leeds doctors have been out working in all the towns and cities across Yorkshire, at 17 different locations, over the past decade. We have a well-established network of services. Those are just a few examples of the kind of impact that the proposal could have on any of our families.

[Fabian Hamilton (Leeds North East) (Lab)]

I congratulate the hon. Gentleman on securing the debate, which, as he rightly points out, is extremely important. Does he agree that it is not just the children’s congenital heart problem services that serve us so well at Leeds general infirmary, but the post-16 services, which the review did not take into account? Does he also agree that Leeds is perhaps the leading centre in the country for training post-16 congenital heart problem surgeons in what is a valuable and important skill?

[Stuart Andrew]

The hon. Gentleman makes an absolutely first-class point. Indeed, I think we have all asked the question: why is the review into children’s services being held separately from that into adults’ services? It is bizarre. We know that the surgeons operating on adults are often the same people who operate on children. We have yet to get a sufficient explanation of why the reviews have not been run in tandem, and we expect, or at least hope, that the Independent Reconfiguration Panel will consider that issue.

That brings me on to my next point. I wholeheartedly welcome the fact that the Secretary of State has decided to refer the decision to the Independent Reconfiguration Panel—that is great news—but it is absolutely crucial that we get the decision right. There is no point in simply reviewing the decision; we want the panel to consider the whole process, right down to the information that was used at the very beginning regarding what the services were like at the different units. That must include the scoring.

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[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I congratulate the hon. Member for Pudsey (Stuart Andrew) on securing the debate, and on the way in which he and other Members across the House have put their case. The issues surrounding Leeds children’s heart surgery unit are important and certainly merit our debate. I also take the point made by the hon. Member for Leeds North West (Greg Mulholland) that a wider debate on the Floor of the House may be warranted.

I take this opportunity to pay tribute to the dedicated NHS staff who work in children’s heart services, both in Leeds and across the country. We are all incredibly grateful for the tremendous job that they do, more often than not in complex, difficult circumstances.

Clinicians and professional bodies, including the Royal College of Nursing and the Royal College of Paediatrics and Child Health, have been clear that children’s heart services need to change. Surgeons are too thinly spread, and services have grown in an ad hoc manner in England, which, to be fair, the hon. Member for Pudsey recognised in his opening speech. Changing how we provide any hospital service is difficult, but when changes are necessary to improve patient care, as they may be for children’s heart services, politicians on both sides of the House should be prepared to listen to that argument and, if necessary, support it.

I know, however, that there have been real concerns and a great deal of protest in the communities surrounding the unit at Leeds general infirmary, particularly about the plans to close it. A motion of support from Leeds city council has been supported by people from across the political spectrum in the city. There has also been a large protest in Millennium square in Leeds, where, I am informed, over 3,000 protestors were joined by local MPs, parents and nurses to campaign to prevent the closure.

As we have heard today, there are similar concerns about plans to close the Glenfield hospital in Leicester, and the Royal Brompton in Chelsea, west London. That could mean that in future, children’s heart surgery would remain at the London children’s hospitals, and in Southampton, Birmingham, Bristol, Newcastle and Liverpool. Although the Opposition support the principle of fewer, more specialist centres, we have concerns about the location of the selected sites, which would leave a huge swathe of the east of England, from Newcastle right down to London, potentially without a centre.

As we have heard, the unit based at Leeds general infirmary serves the 5.5 million residents of Yorkshire and the Humber, and performs 360 operations a year, done by three surgeons. We have heard, too, that there are concerns that the closure of the unit will leave millions of people in the region without local access to the children’s heart surgery expertise that currently exists in Yorkshire and the Humber at Leeds. The local Save Our Surgery campaign group, under the Children’s Heart Surgery Fund, believes that families from Yorkshire, north Lincoln and the wider Humber region may have to travel up to 150 miles for treatment at the nearest unit in Newcastle or Liverpool, if the closure goes ahead.

As an aside, I was privileged to visit the hospital in Hull, at the invitation of my hon. Friend the Member for Kingston upon Hull North (Diana Johnson), as part of my duties as a shadow Health Minister. It took me an hour and a half to get from Manchester to Hull to visit the hospital. However, because there was a slight flurry of snow on the way back, the M62 ground to a halt, and it took me over five hours to get back over the Pennines to Manchester. I have never seen so many Lancastrians trying to desert Yorkshire at the same time as me, but it shows that geography matters in such decisions. We cannot ignore the fact that the Pennines are there, and sometimes they are impenetrable.

Clearly, there is concern that families may be faced with having to travel further at what is undeniably a very stressful time for them. That case has been made eloquently by Members on both sides of the House in the debate. It is also worth remembering that it is not only the care of poorly children that needs to be taken into account; the care of the whole family is important.

I ask the Minister, for whom I have a great deal of respect, whether she was satisfied that the NHS joint committee of primary care trusts properly balanced clinical decisions with practical and transport issues for families. Furthermore, does she believe that the review was fair to families in the eastern half of England, which is now left with no centre between Newcastle and London? As we know, the JCPCT came to the decision in July to close the unit. The SOS campaign group launched legal proceedings against the NHS to stop the unit being closed, submitting an application to the High Court for permission for a judicial review. Last week, as we have heard, the Health Secretary asked the Independent Reconfiguration Panel to review the decision to close three centres.

We know that children’s heart surgery matters greatly to many people. However, as we also know, the issues surrounding children’s heart surgery have needed to be resolved for some time. The findings of the Bristol Royal infirmary inquiry into children’s heart surgery 10 years ago highlighted that between 1990 and 1995, a number of children died at the infirmary as a result of poor care. It is clear that children’s heart surgery has become an increasingly complex treatment. The aim must be for children’s heart services to deliver the very highest standard of care. The NHS should use its skills and resources collectively to gain the best outcomes for patients. The Government rightly want changes to children’s heart surgery services, so that they provide not only safe standards of care, but excellent, high quality standards for every child in every part of the country.

[Fabian Hamilton]

Does my hon. Friend agree that it is not only the continuum of children’s heart services and the care of parents and other family members that is important? The treatment should continue beyond 16, if it has to. There needs to be an overview of pre- and post-16 services; they should be taken together, because that is how we ensure that the young person, who becomes an adult, survives and lives the rest of their life.

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[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

Here we are again. It is a pleasure to speak under your chairmanship, Mr Hollobone. It is about a week since we had a very similar debate, also under your chairmanship. That has already been described by my right hon. Friend—sorry, I always call my hon. Friend the Member for Pudsey (Stuart Andrew) the right hon. Member for Pudsey. [Hon. Members: “Soon!”] Perhaps I am trying to elevate him too soon, but as he has explained, we had a similar debate only last week about the situation at Glenfield. I join everyone else in paying tribute to him for securing this debate.

I pay tribute to all hon. Members who have spoken, of whatever party. In many ways, this has not actually been a debate, because normally in a debate there is a degree of disagreement and people put forward their arguments for or against a particular motion or notion, but that has not been the case in this debate. Here, we have had an outbreak of complete unity, which I acknowledge, between all political parties. It is right and proper that, on this matter, people come together, are not divided by political party and are determined not to score any form of party political point in making their argument. All hon. Members have come to this debate for the right reasons. They have come to represent their constituents and to put forward all the arguments that they can on behalf of their constituents and with full force. That is absolutely right and as it should be, but I want to make this point as well, and not because I am any form of coward—after all, I spent 16 years defending, largely, the indefensible.

I have to say that the hon. Member for Denton and Reddish (Andrew Gwynne) was treading somewhat on my good humour with some of his remarks when he was asking me for my opinion because, as we all know, this whole review has taken great pride in the fact that it has been an independent review—independent of Government. It was set up, quite properly, by the last Government, on a cross-party basis, and it was on the basis that we needed fewer but larger and more specialised children’s heart services in England. It was accepted—I say this with great respect to my hon. Friend the Member for Cleethorpes (Martin Vickers)—that that was the basis of it all and that it was being done so that we could secure the best children’s heart services for babies and young children that we could possibly obtain, and so that we could ensure that those services were sustainable. We wanted to concentrate the specialist heart surgeons in a smaller number of centres to ensure that they had the best skills for dealing with babies and young children.

At the end of the day, we are talking about arguably some of the most specialised surgery that exists. There are instances in which surgeons are operating on a baby’s heart that is no bigger than a walnut. As I say, it is perhaps the most specialised and the most precarious of all types of surgery, so their skills have to be the best. It is also the case that if we have fewer, but larger, more specialised units, we can ensure that those surgeons, those doctors, those nurses and the other health professionals are training the future surgeons, doctors, nurses and other health professionals to do this very important and highly specialised work.

I pay tribute to my hon. Friend the Member for Pudsey. As we would all have expected, he advanced a thoughtful, well researched and sound set of arguments on behalf of his constituents. He gave the examples of Lauren, Libby and Abi. The hon. Member for Scunthorpe (Nic Dakin) also spoke with considerable feeling about what his constituents had told him. That is only right and proper. I am sure that all those constituents will welcome the comments of their Members of Parliament in advancing their arguments for keeping their children’s heart surgery unit open. It is quite clear from the various interventions that this has all-party support. We heard from my hon. Friend the Member for Shipley (Philip Davies), the right hon. Member for Leeds Central (Hilary Benn) and my hon. Friends the Members for Skipton and Ripon (Julian Smith) and for Brigg and Goole (Andrew Percy). As I said, people are coming together, whatever political differences they might otherwise have, in agreement and in support of children’s heart surgery at Leeds general infirmary.

A number of matters strike me from the speeches that have been made. In addressing some of the remarks made and arguments advanced by hon. Members on both sides of the Chamber, I shall try to give a response that perhaps allays some fears and certainly answers some questions.

[Fabian Hamilton]

I am sorry to intervene when the Minister is about to give those responses, but she said that the review, quite rightly, was independent; it was set up by the previous Government to be independent of Government. I think that the prevailing view this afternoon is that it was not impartial. Will she comment on that?

[Anna Soubry]

I will not comment on that, quite deliberately, because it is imperative that I am seen and, indeed, fellow Ministers are seen to be completely independent and impartial ourselves. Of course, that does not prevent hon. Members from making their own judgments and vocalising them, and there may be merit in them, but it is not for me to say whether there is, because, as hon. Members know, this has all been referred to the Independent Reconfiguration Panel—that is right and proper, in my view—and it will look at all aspects of how these decisions have been made. It will take evidence not just from the NHS, clinicians and local authorities, but from Members of Parliament. I am in no doubt that all hon. Members who are here today will make their own representations to the IRP on behalf of the children’s heart services at Leeds general infirmary and will make them with the force with which they have made them today and on the basis of as much information, sound evidence and argument as they have shown us here today.