Leeds Children’s Heart Surgery Unit

Julian Smith Excerpts

Tuesday 30th October 2012 Westminster Hall

[Stuart Andrew]

I am grateful for my hon. Friend’s kind words. It has been a tremendous cross-party campaign. People right across our region have been speaking in high praise of the unit. My hon. Friend is absolutely right that it should be about what patients want. Patient choice is a bedrock of the NHS. I hope that today’s debate will enable us further to put across our grave concerns about the review.

[Julian Smith (Skipton and Ripon) (Con)]

Another concern that people have raised is the initial consultation that took place, especially with regard to the language and translation for a large section of our community who suffer particularly from congenital heart disease. Will my hon. Friend comment on that? Does he think that that issue has been fully addressed thus far in the process?

[Stuart Andrew]

No, I do not. The projections of population growth, particularly in the south Asian community, are a huge issue that has not been fully addressed. I hope that that issue will be taken up by the independent panel when it considers the detail of the decision that was reached.

It would be a backward step for us to go to a unit that was separated from the rest of children’s services by three miles. We have a wonderful unit at Leeds general infirmary, where all the children’s services are under one roof. Staff there talk about the difference between now, and when the unit was at Killingbeck. There were great problems with getting doctors to travel there, even though it was only a couple of miles away. It is unacceptable for our constituents and poorly patients to receive a much lesser overall service, because the rest of the services will be three miles across the city of Newcastle.

A phrase that I have heard a lot in this campaign is, “Bring the doctors to where the patients are and not the other way around.” The review has been inconsistent regarding whether population density matters. The consultation document said that Birmingham gets a high number of referrals because of the large population in its catchment area, and it should therefore remain as a unit, but that simply does not seem to apply to Leeds. Leeds serves a population of some 5.5 million, double the 2.6 million in Newcastle, and projections show that that number will increase. The recent census showed that the population of the north-east had increased by 57,000, compared with an increase of 300,000 in Yorkshire, so surely we should put the services where the population is, and where it is growing.

The health impact assessment stated that options G and I were the only ones to induce few negative impacts—option G being the one that includes Leeds—and it admitted that option B would have a more negative impact than option G. That information was released only at the meeting on 4 July.

I want to talk about public opinion because, as my hon. Friend the Member for Shipley (Philip Davies) mentioned, support for the campaign has been phenomenal. Some 600,000 people have signed a petition, which shows the strength of feeling in our area, but those signatures were counted as just one response, while 22,000 separate text messages in support of Birmingham were counted as 22,000 separate responses. The NHS constitution states that the NHS is guided by several key principles, one of which is:

“NHS services must reflect the needs and preference of patients, their families and their carers. Patients, with their families and carers, where appropriate, will be involved in and consulted on all decisions about their care and treatment.”

The fact that so many people felt compelled to sign the petition shows the strength of feeling that they have.

I have spent a great deal of time in the Leeds unit, speaking to families that use it. One of them is the family of one-month-old Lauren, who had problems with feeding and was referred to the Airedale hospital when she was approximately one week old. A heart problem was then suspected, and she was referred to Leeds general infirmary, which has strong links with Airedale. She was transferred to LGI through Embrace, the Yorkshire and Humber specialist ambulance service—a service that does not exist in Newcastle—and it took four hours to get the baby in a stable enough position to undergo the journey to Leeds. Imagine expecting that child to go all the way to Newcastle. Her mum, Sara, said that she could not understand why, given the size of the population in Leeds and the surrounding areas, as compared to the size of the population in Newcastle, it was contemplated making people travel further and separating them from their often crucial family support. I know from my time at Martin House children’s hospice how important it is to have family support close by. The patients are in incredibly stressful situations, and it is critical that others can share in the care and visit the children.

[Julian Smith]

What assurances has my hon. Friend had regarding ambulance services? He is right that Embrace, the Leeds service that looks after children in getting them from home to hospital, is second to none. How will Newcastle get anywhere near that quality of service in the time scale required?

[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.

--- Later in debate ---

[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.

[Julian Smith]

Will the Minister give way?

[Anna Soubry]

I was going to try to move on to some of the issues, but I will happily give way.

[Julian Smith]

I thank the Minister for giving way. Can she confirm that the panel will include some people who are actually living in the north? What is the make-up of the panel?

[Anna Soubry]

I shall be absolutely blunt: I cannot answer that question. I took a strong view some time ago that if I did not know the answer to a question, I would say so. However, I am more than happy to write to my hon. Friend and answer his question as much as I can.

Travelling times were mentioned by a number of hon. Members. I was going to go through all those who mentioned them, but I may not have time to do so. I shall just make this point. Of course, it is surgery that it is proposed will be lost from Leeds and will go to Newcastle. It is very important that all hon. Members, when they communicate to their constituents about this debate, make the point that the plan is that the surgery will take place in Newcastle, but all the follow-up, all the support and all the other things that we might imagine are involved when a baby or a small child has surgery will continue to be provided at Leeds. It is not the case that the whole thing will move up to Newcastle; it is simply the surgery. I just put that into the pot because the point was made about travelling times. Of course, it is for others to say, but it may be that they take the view that those were very good points that hon. Members advanced in the debate today.

The hon. Member for Leeds East (Mr Mudie) asked specifically about the JCPCT’s refusal, or otherwise, to disclose information. The hon. Member for Leeds North West (Greg Mulholland) spoke with passion, as ever, and commented on that, as did my hon. Friend the Member for Pudsey and other hon. Members. It is for the JCPCT to decide what information should be disclosed, in accordance with the requirements of the Freedom of Information Act. I am told that the Yorkshire overview and scrutiny committee has indicated its intention to refer the matter to the Information Commissioner, which is the established recourse laid down by legislation. I am afraid that it is not for Ministers to order the JCPCT to disclose information to the OSC in Yorkshire or any of the other local authorities involved. The various authorities are open to make applications under the Freedom of Information Act. I hope that answer deals with that point.

The powerful arguments the hon. Member for Leeds East put forward were largely based on population figures. I have already alluded to the contribution of my hon. Friend the Member for Cleethorpes. In large part, my hon. Friend and I disagree on the basis of the review. He said that different experts have different views, but I have to tell him that we have seen an outbreak of unity on this issue among many of the royal colleges, experts and leading clinicians in the field, who welcomed the decision of the JCPCT.