Congenital Cardiac Services for Children

George Mudie Excerpts

Thursday 23rd June 2011 Commons Chamber

[Mr George Mudie (Leeds East) (Lab)]

I congratulate the hon. Member for Pudsey (Stuart Andrew) on the hard work he has put in to secure this debate. I compliment him on the sensitivity with which he phrased his contribution. I hope that that will allow the Government Whips to stay out of the decision and allow Members to get what we seek, which is not interference in clinical observations, but a review of how this is being carried out geographically.

The right hon. Member for Charnwood (Mr Dorrell) was more sanguine than I am about the involvement of Sir Bruce Keogh, the NHS medical director. I found his article in The Times this morning ill-timed, coming on the morning of a debate, when feelings are running high. I do not find it acceptable for him to say that anyone who opposes his view is “disingenuous” and that

“political interests conspire to perpetuate mediocrity and inhibit the pursuit of excellence.”

I find that offensive. Nobody in the Chamber argues with the clinical objectives. I find it unacceptable that some youngsters who are taken to centres for medical treatment get excellent treatment and that others get less than excellent treatment. I find it sensible and laudable that we should rationalise those centres to build up experience and techniques, and so that there are more people to share their experiences.

The right hon. Member for Charnwood said that we should not oppose the proposal because it is right clinically. He told us not to think of our own hospitals, but to think nationally. “Nationally”, however, also means “regionally”. The point that has not been made is that, while the Chamber should accept the clinical arguments, equality of access is also important. That is what is being said by most of the opponents of the proposals, and they are not being disingenuous. For instance, in the Newcastle versus Leeds argument, it would not be acceptable for me to argue in favour of the Leeds case on the basis that Leeds children should not have to travel 100 miles to Newcastle, because if we won our case, Newcastle children would have to travel 100 miles to Leeds. If it is wrong for us, it is wrong for them.

If the rationalisation, which we accept, takes place properly—and this is where the Minister comes in—there will be an underlay of fairness and equality of access. We have a National Theatre in London, but it is not a National Theatre for Yorkshire. It is nice for Hampstead, but it is not very good for Seacroft in Leeds.

[Mr Dorrell]

I think that the hon. Gentleman slightly misrepresented what I said. I did not say, “You must accept it”, or “Take it or leave it”. I said that those who wished to argue for a different approach must argue for the whole approach, and not for a sectional interest.

[Mr Mudie]

I entirely accept that, and I did not intend to suggest that the right hon. Gentleman had said anything different. My point is that, while the clinical case for a rationalisation is unarguable, equality of access is as important a consideration as any. Excellent treatment must not be available to only a certain number of people.

[Greg Mulholland]

We all accept the clinical premise of the review, but is it not incredibly arrogant for anyone to suggest that it cannot be fallible? There are obvious flaws in it. Many clinicians themselves say that it is flawed.

[Mr Mudie]

I hear what the hon. Gentleman says. I think that the same case was made by the right hon. Member for Charnwood. We may prevaricate for one reason or another, but sometimes it may be necessary to make a decision even when we think that it is not perfect, and I think that this is an instance of that. If the life of a child is involved, we must make a decision.

If we continue to challenge the clinical aspect of the review, we will fall into the trap of allowing a bad situation to continue. The case for change has been proved, and, while we may differ on how that change should be made, what is important is for us to express the view—and I should like to see it challenged—that there should be equality of access. Each region should ensure that every part of it has equality of access where possible, although that will involve some difficulty if Yorkshire is lumped together with the north-east.

In the last year I have had to move from my constituency office, which was in the centre of the constituency. I was offered cheaper, perhaps even better, accommodation in the outer part, but I felt that it would be unfair on the other wards for me to move away from the centre. If option 4 is either Leeds or Newcastle, I think that that is unfair on both. I do not want to close Newcastle, and Newcastle does not want to close Leeds. Locating provision sensibly in each region is important, but the House should also recognise, as it rarely does, that the country has some corners in which there is no equality of access in any respect. Those in Newcastle, in the top corner, and those in Cornwall, in the bottom corner, do not have access to many facilities that are accessible to people in the midlands, in Yorkshire and, above all, in London.

I believe that the House should accept the motion, and that the review team should forget about the clinical arguments and produce a template that proves to every Member that the excellent services that we should be demanding for children’s care will be shared equally around the country. The team should give some real, positive, out-of-the-box thought to how to deal with areas that generally lose out.

--- Later in debate ---

[Greg Mulholland]

I have not yet had a chance to congratulate my hon. Friend on the way in which he has co-ordinated our campaign. It has been a pleasure to work with him so closely, and I look forward to continuing to work with him and other colleagues. He is right: one of those serious flaws is the failure to consider the impact on adult heart services, which would be a huge problem.

There is real concern out there, as has been demonstrated not only by the petition in Yorkshire and petitions in other parts of the country, but by the views expressed by many respected practising and retired clinicians. The concern about the closures is understandable, but there is also concern about the review itself. There is concern about the process, about the conclusions reached so far, about the lack of consistency in the recommendations, about the lack of logic in relation to the premise of the review, and, I am sorry to say, about a lack of impartiality.

That is why it is right for the House to have an opportunity to express that concern on behalf of all the areas concerned, and why it is fitting that the Minister of State, Department of Health, the right hon. Member for Chelmsford (Mr Burns), is present. I thank the Minister for the way in which he has engaged with us, and I urge Members in all parts of the House to support the motion, so that we can address the concern that has been expressed outside and inside the House by considering the possibility of other configurations.

I wish to echo three points that have been made about the wonderful Leeds unit. The first is about the co-location of services. The unit is a case of true co-location, which is what the British Congenital Cardiac Association has called “gold standard” care. Leeds is currently one of only two hospitals shown in the review to have such a type and level of service. Mr Joe Mellor, a consultant anaesthetist at Leeds, says:

“What is particularly upsetting about the proposals is that our patients from Yorkshire would leave the Leeds unit and have to travel to Newcastle or Leicester. Leeds has centralised all its children’s services onto one site. Neither Newcastle nor Leicester have come close to achieving this. Congenital cardiac surgery is a very complicated form of medical treatment. If in Leeds we encounter a problem where the child needs the help of an intestinal surgeon, or a neurosurgeon, or need renal therapy, or a host of other possible therapy, then we get it immediately in our own children’s hospital.”

Jonathan Darling, a consultant paediatrician at the Leeds General infirmary, states:

“To lose heart surgery from the Leeds Children’s hospital would be a huge blow, especially when we have just centralised services precisely to realise the benefits of having all paediatric services co-located on one site. The Review process does not seem to give sufficient weighting to this true co-location.”

I am afraid that it simply has not done so, which is worrying and quite extraordinary.

The second point that I wish to make is on the issue of population, which colleagues from the region have already raised. It simply makes no sense to close a wonderful unit that is already performing almost the number of operations that it must, when there are so many people in the area and the population is growing. I echo the comments of the hon. Member for Leeds East (Mr Mudie) when I say that of course we do not want to see the Newcastle unit close. We do not want to see any unit close, because this is about getting things right. However, I say to him and others that it would be absolutely perverse to close Leeds simply to enable Newcastle to perform a sufficient number of operations. If we stick to the number in the review, Newcastle can only perform that number of operations if Leeds closes. That is absurd.

[Mr Mudie]

The point I was making was that if we are to take the review’s point and place units strategically, the obvious place with a mass population is Leeds. However, I said that that would leave Newcastle out on a limb, and something has to be done about that. The case for Leeds is unchallengeable.

[Greg Mulholland]

Indeed, and we have to get the point across to colleagues in other areas that perhaps we have to challenge the premise of the review and some of its figures if we are to reach other recommendations.

The third matter that I wish to mention, as the hon. Gentleman did, is travel. In the meeting yesterday with the review team, I was frankly dismayed by how little consideration was being given to the reality of ordinary working families and the effect that having to travel would have on them. I shall give a couple of examples. Johanne Walters, the mother of Emma, states that to them the change

“would mean her…surgery will be undertaken miles away from home and nobody would be there to support me—no family no friends—and it is incredibly difficult being there 24/7 at your child’s bedside, even with this support”.

Joanne and David Binns, whose son Oliver has been treated, have said:

“Oliver is our only child, and I’m sure you can imagine how it turned our world upside down. But we knew that we had family and friends who could just pop in and make us some food at the end of a long day, bring us clean clothes, and just be there if we needed a chat. I can’t imagine how much extra pressure it would have been at this point to have to think about long distance travel and accommodation on top of everything else.”

Matthew and Karen are the parents of Liam Hey, a constituent of mine who has become something of a celebrity. He is a wonderful young man who is being treated at Leeds. Karen has said:

“My son would not be here if it wasn’t for the LGI. It would be too much of a trauma to transfer children to another place.”

Travel has simply not received adequate consideration. It comes out top of the criteria that people give when we ask them, but it is not anywhere near the top of the list of the review’s considerations. That is wrong.

We have to re-examine the situation. I am delighted that the House has had a chance to debate it today, and that Ministers have been so accommodating in enabling us to do so. I urge the House to support the motion. We should come back with some proposals that will really work for children and that we can all support.