Health: Congenital Heart Disease

Lord Patel Excerpts

Thursday 20th July 2017 Lords Chamber

[Lord Patel (CB)]

My Lords, I start by congratulating the noble Baroness, Lady Boothroyd, on securing this debate, even at the last minute before the summer starts. She ended her brilliant speech by presenting the evidence why the Brompton is so important and should not be closed. The Brompton’s international reputation derives from its eminence as an innovator in care and its reputation in international research, which is what I will refer to.

To give an example of the hospital as an innovator in care, I mention the case of Chloe Narbonne, a 13 year-old girl from Worcester who had been diagnosed with cardiomyopathy at the age of four weeks, and required a heart transplant. Her second heart transplant failed, meaning that she faced death because she would have to wait some time for another heart to be available. At that time, the doctors at the Brompton decided to implant an artificial heart. It was the first artificial heart implanted in a child in the whole of Europe. Since then, the surgeon involved, André Simon, has conducted 13 implantations of an artificial heart. That kind of cutting-edge innovation occurs only in an institution of very high standing, where highly skilled doctors and nurses practise. This is an example of a hospital that innovates care.

I have two examples of how important this institution is to research. The first is a report by the National Institute for Health Research about the hospital’s performance as an academic institution in 2016-17, which says that the trust achieved 104% of its overall recruitment target; 17 non-commercial studies that closed last year recruited in time and on target; and the trust increased its participation in the commercial portfolio, recruiting to 38 commercial studies—an increase from the previous year. Despite respiratory recruitment falling since 2015-16 in the Brompton, it remained the highest recruiting trust in the country in the NIHR respiratory portfolio, and contributed 8% of the national portfolio—a huge number. Some 75% of non-commercial cardiovascular studies and 80% of commercial cardiovascular studies closed on time and on target—a remarkable achievement for an academic institution.

An analysis from the RAND Corporation shows that the Royal Brompton publishes more highly cited papers on both respiratory and cardiovascular medicine than any other NHS trust in the United Kingdom—in scientific work, how many times your papers are cited is a mark of your original contribution to science. The trust is the UK’s flagship centre for research on adult CHD and is widely recognised as the world’s leading institution in CHD research. The hospital is funded by bodies including the National Institute for Health Research and the British Heart Foundation. In fact, the British Heart Foundation funds one of the only full-time academics working in CHD research in the country.

The combination of factors that makes the trust so prolific and influential—the lifelong rather than separate paediatric and adult patient care; the large patient populations; the multidisciplinary expert teams; and the culture of vision and drive that has been cultivated over many years—cannot be replaced if people move elsewhere, as NHS England suggests. Teams get broken up. It takes years to build research teams, particularly in academic medicine, so for the NHS to suggest that this proposal will not have any effect is fundamentally and absolutely wrong.

Last August, the Secretary of State for BEIS vowed that:

“The government’s commitment to our world-leading science and research base remains steadfast”.


The Minister of State for science and research commented in the same month that,

“it’s more important than ever that we support the brightest and best researchers and innovators”.

I hope that the new Government will take the opportunity to prove that their enthusiasm for and commitment to British research remain steadfast and undiminished. I suggest that that could be achieved by the Government forcing the NHS to change its mind about closing the Brompton.