Leeds Children’s Heart Surgery Unit

Martin Vickers Excerpts

Tuesday 30th October 2012 Westminster Hall

[Martin Vickers (Cleethorpes) (Con)]

It is a pleasure to take part in a debate under your chairmanship again, Mr Hollobone. I, too, congratulate my hon. Friend the Member for Pudsey (Stuart Andrew). This is something of an action replay, not only for you, Mr Hollobone—you were in the Chair last week for the debate on Glenfield hospital in Leicester—but for the Minister. I apologise to her that some of the points that I am going to press her on now are identical to those that I raised last week. One is the point about distance.

It is noticeable that three out of the four representatives from northern Lincolnshire are here to take part in the debate. We are the remotest part of the area served by the hospital. That does not just present problems for people visiting. As we have heard in previous debates and meetings, getting babies to a unit has actually made the difference between life and death, and that cannot be ignored. In the Cleethorpes area, there are a large number of parents and grandparents whose children have received treatment here. We held a public meeting in July and the strength of opinion was evident.

In last week’s debate on the Leicester unit I was slightly disappointed by the Minister’s response. I appreciate that she is walking a tightrope, but she is noted for being an independent voice. She showed signs of being sucked into the departmental bureaucratic nonsense that we often hear, but I am sure she will rectify that in half an hour’s time. Commenting in her reply on something that I said, she made the perfectly valid point that in cases of the kind that we are considering we want

“fewer, but much bigger units.”—[Official Report, 22 October 2012; Vol. 551, c. 186WH.]

That is the opinion of some experts, but equally, of course, other experts disagree. If we are to be ruled by expert opinion, there are two possibilities. One is that we pack up and go home, because we are superfluous. The other is that because experts always disagree, someone democratically accountable is needed to arbitrate between them. My hon. Friend the Member for Brigg and Goole (Andrew Percy) wishes to intervene, as usual.

[Andrew Percy (Brigg and Goole) (Con)]

I want to intervene to defend the Minister. My hon. Friend is entirely right about the geographical problems in our area; but even if we accept the argument that we need bigger units, is not the core issue the fact that the population—the patient base—is in our region, not in the north-east? If we must go along this line—let us assume that we must—we should move the doctors to where the patients are, not the other way around.

[Martin Vickers]

As usual, my hon. Friend and neighbour is correct. Because of the remoteness and so on, the assumption that all patients in northern Lincolnshire will transfer to Newcastle will simply not be borne out. They will choose alternatives and I suggest that most will gravitate south. Therefore the Newcastle target of 403 will not be achieved.

There are expert opinions on both sides of the argument. The significant point is that the parents and grandparents of the children who receive the treatment are not convinced about the alternatives, because they have seen surgeons and other experts in Leeds performing miracles on their children with modern medical technology. That is their doubt: they do not have confidence in the alternatives when they have seen the Leeds centre of excellence in action.

My hon. Friend the Member for Pudsey stole a line from me because I too was going to quote the point that my hon. and learned Friend the Member for Harborough (Sir Edward Garnier) made in last week’s debate. I will take another line from his speech:

“The Secretary of State has the levers of power in this question and he must pull them—he must exercise them”.—[Official Report, 22 October 2012; Vol. 551, c. 188WH.]

That is what we expect. We do not want the question shuffled off to a panel of experts, with automatic acceptance of what they say. Different experts come up with different decisions.

Time is pressing. In Leeds we have a centre of excellence. It deserves our support, and already has the support of those we represent. I am sure that the Minister and the Secretary of State would not want to be responsible for destroying it.

[Mr Philip Hollobone (in the Chair)]

If the final three hon. Members who want to speak in the debate take five minutes, they will all get in.

--- Later in debate ---

[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.

[Martin Vickers]

We heard from my hon. Friend the Member for Leeds North West that experts in Scotland disagree, so there is clearly some basis for doubt.

[Anna Soubry]

I am grateful for that contribution, but I know that when the JCPCT’s decision was announced, it was universally welcomed by many of the clinicians who have been involved in such specialised surgery, certainly throughout England, but I cannot comment on the views of those north of the border.

I have a short time left to speak. The Independent Reconfiguration Panel is just that—an independent reconfiguration panel. I can provide details to those who need to know its composition. It comprises independent experts, and Members can be assured that they will conduct a full and independent review. As I said, they will take evidence from NHS organisations, local authorities and local MPs. It is hoped that their deliberations will conclude at the end of February. It will then be for the Secretary of State to receive the findings and recommendations and to decide whether to act on them. There is a concern that there may be some delay due to a legal challenge.

In last Monday’s debate my hon. Friend the Member for Pudsey made a helpful intervention, to which I responded that if any local authorities in Yorkshire are minded through their OCSs to refer the matter to the IRP, they should get on and do it. I want to put that into the pot, because the one thing that nobody wants is any more delay.

This debate began back in the 1990s, and hon. Members talked about what happened in Bristol. It was determined then that we needed to ensure that our babies and young children had the finest specialised heart surgery services possible, which is why it has been a long process. It is difficult and painful, but the Safe and Sustainable review was set up on the basis that there would be a reduction in the number of units. No one wants to set one hospital against another, and I pay tribute to everyone who has avoided doing so, but unfortunately sometimes tough decisions have to be made. It is always important to remind ourselves that they are made for the very best reason, which is to ensure that our babies and young people are safe and get the very best service.

Children’s Cardiac Surgery (Glenfield)

Martin Vickers Excerpts

Monday 22nd October 2012 Westminster Hall

[Martin Vickers (Cleethorpes) (Con)]

It is a pleasure once again to take part in a debate under your chairmanship, Mr Hollobone. I join other hon. Members in congratulating my hon. and learned Friend the Member for Harborough (Sir Edward Garnier) on securing the debate.

I feel like something of an intruder, coming from the remote parts of Lincolnshire to this east midlands event. I rise to speak because many of my constituents’ children and grandchildren have received treatment at Glenfield and Leeds, and I have campaigned with my hon. Friend the Member for Pudsey (Stuart Andrew) for the retention of the Leeds unit. We have centres of excellence and we want to retain them. My constituency is at the end of the line and somewhat remote, so the geography of where people receive life-or-death treatment is of particular concern. We joined the campaign for the Leeds unit and heard from parents how the distance to the life-saving unit has made a big difference. Cleethorpes is 80 miles from Leeds and 90 miles from Leicester.

The alternatives suggested to my constituents—in Newcastle—have been a significant factor in the opposition to the proposed changes. We already feel remote and out of it. I do not want to be frivolous, but if, for example, some of my constituents were involved in an accident, Humberside police would attend and summon an ambulance from the east midlands, which would then take them to Grimsby hospital, which is administered by the Northern Lincolnshire and Goole Hospitals NHS Foundation Trust. All these factors give people a sense of unease, and a sense that they are at the end of the line and do not matter. It is essential that we ensure that services are as close as possible to the people.

Parents will go to the ends of the earth to take their children to emergency treatment, but as a national health service we have to ensure that services are, wherever possible, as close as possible to the centres of population. We need to bear in mind the need to have centres of excellence, which, as the clinicians constantly tell us, means more and more concentration, but remoteness will mean that these proposals are unlikely to be achieved.

[Stuart Andrew (Pudsey) (Con)]

My hon. Friend is making an important point. The Safe and Sustainable review found, from its own independent advice, that patients in his constituency would not travel to the units that would be kept open under the proposals.

[Martin Vickers]

My hon. Friend is right. I think it was proposed that the likely number of operations taking place in Newcastle would be 403. That will not be achieved, because people in Cleethorpes and northern Lincolnshire will not travel to Newcastle; they will look for alternatives. With doubts being cast on the centre at Birmingham, inevitably, if Leeds and Glenfield closed, people would gravitate south rather than towards Newcastle.

We have heard expressions of concern about the process of consultation, and there is no doubt that the view that the consultation was flawed is widespread. Indeed, my hon. Friend the Member for Pudsey drew attention to that in an Adjournment debate a few weeks ago. I appreciate that the Minister said, in an intervention, that the review was by clinicians. The problem is that clinicians always tend to want to gather together in more and bigger centres of excellence, and our constituents want as local a service as possible.

I hope that when the Minister and the Secretary of State make their decision they will consider other aspects. The expertise of the professionals is important, but access to services is also important. The last thing that people want is a decision that comes from a review by people they do not know and about whom they are doubtful—expert opinion—at the best of times. They want the Secretary of State to weigh up all the factors, not just the expertise. Parents and grandparents of children who have received treatment from these units know, from personal experience, the care and attention that they provide, and they fear being shunted away.

We have centres of excellence. Please, Minister, do not rubber stamp a review that wants to close them. Consider, first of all, the children who are treated by these centres.

health

Martin Vickers Excerpts

Tuesday 18th September 2012 Commons Chamber

[Stuart Andrew]

I am grateful for that intervention, which brings me on to exactly that point. The review’s decision said that 25% of Leeds, Wakefield, Doncaster and Sheffield patients would go to Newcastle, when its own evidence said that they simply would not. Funnily enough, if 25% of those patients go to Newcastle, guess what? Suddenly, 403 patients a year will have surgical operations in Newcastle, which is just three more than the magic figure of 400. I do not believe that that 25% will exist, so Newcastle will miss the target of 400 operations, which is a key plank of the whole review.

We have heard about how public opinion has been discounted. A petition signed by more than 600,000 people was brought down to Downing street. That is an enormous number for one region, yet the review counted it as just one response. On the other hand, 22,000 text messages received in support of Birmingham were counted as 22,000 separate responses, which is blatantly unfair.

One of the most important issues is the co-location of services. What has impressed me about the Leeds unit is that it is part of the Leeds children’s hospital. All other surgeons get there within minutes, if needed. We are asking our patients in our constituencies to go to Newcastle, where all other services are some 3 miles away from the heart surgery unit. That is simply not acceptable and goes against the advice of the key recommendation of the Bristol inquiry, which was backed by the British Congenital Cardiac Association. The inquiry said:

“For these services at each centre to remain sustainable in the long term, co-location of key clinical services on one site is essential.”

It is important that we do not forget that.

The fact is that, allowing for patient choice and without the flow of patients from the populous areas of Yorkshire, as evidenced by the PricewaterhouseCoopers research, Newcastle will not reach the target of 400 surgical procedures. In 2010-11, Leeds delivered 336 procedures against Newcastle’s 271.

The impact assessment also showed that the options that included Leeds would have fewer negative impacts and that option B, which included Newcastle, would be particularly damaging for paediatric intensive care in Yorkshire and Humber.

It is also important to ask why Birmingham was chosen because of its density of population and Leeds was not, given the fact that we have a high south Asian population who, statistically, are more likely to need the service. As we have said time and again, doctors should go where the patients are, not the other way around.

Sheffield parents whom I have met at the unit travel three times a day to visit their children in hospital, because they have other children at home. We have to think about the impact this has on families.

[Martin Vickers (Cleethorpes) (Con)]

I congratulate my hon. Friend on his work on this issue. His point about distance is particularly relevant to my constituency. Cleethorpes is about 85 miles from Leeds and the parents will not travel to Newcastle, so it will not reach that figure of 403.

[Stuart Andrew]

I am grateful to my hon. Friend for the support that he has given to the campaign by meeting his own constituents who, he is right to say, will not travel to Newcastle. His comments further highlight the ludicrous nature of the decision.

I have presented the problem, so what is the solution? I recognise that the review is independent of Government, but we have to tackle the problem—it will not go away, because we as Yorkshire, Lincolnshire and Humberside MPs will not let it. Our view is that the review could happily be implemented elsewhere, that both Leeds and Newcastle should be kept open and that a decision on their future should be delayed until April 2014. That would provide an opportunity for patients and parents who require the services to exercise their constitutional right to patient choice and to determine which centre they wish to access. By the end of that period, each centre would have to demonstrate that they were fully compliant with all the standards set by the Safe and Sustainable review.

This solution would amount to only a one-year pause. Given that legal proceedings are likely to take place, there will be a one-year pause in any case. The reconfiguration of all children’s heart surgery centres in England is not due to commence until April 2014 and a decision taken at that time on Leeds and Newcastle could be implemented in 2015. The definition of a centre that delivers a sustainable service is that it should have a minimum of four surgeons, so if, after the one-year pause, commissioners did not think that the Newcastle unit had a sufficient work load, the Leeds unit could explore how it could provide support in conjunction with Newcastle.

If either of the centres did not meet the standards, it would, frankly, let itself down. This solution gives them the opportunity to provide the services that families are so desperate to keep. There are many benefits to the solution: it would avoid the risk of a costly judicial action from supporters of either unit, which could sink the review in its entirety; it would give Leeds and Newcastle the opportunity to demonstrate their compliance with the safe and sustainable standards, which is what we all want; it would allow the less controversial decisions made by the JCPCT to proceed elsewhere in the country; and it would show, frankly, that the Government are listening to the concerns of the 600,000 people who signed our petition, and I am sure that the public would respond accordingly.

I know that this is not an easy decision, but there is a great deal of concern and anxiety in our region. I hope that the Government will not just give us the line that this is a review independent of Government, but acknowledge that there are serious concerns and great anxiety among our patients and families, and that it is time to look at the issue in detail, to listen and to act.

Care of the Dying

Martin Vickers Excerpts

Tuesday 17th January 2012 Westminster Hall

[Martin Vickers (Cleethorpes) (Con)]

I, too, congratulate my hon. Friend the Member for Enfield, Southgate (Mr Burrowes) on securing the debate. Bearing in mind your request for brevity, Sir Roger, I will be as brief as possible. I can only agree with much if not all of what has been said.

In considering what to contribute to the debate, I looked up a definition of palliative care. We tend to know what that means, but the definition that I came across last night is from the National Institute for Health and Clinical Excellence:

“Palliative care is the active holistic care of patients with advanced progressive illness. Management of pain and other symptoms and provision of psychological, social and spiritual support is paramount. The goal of palliative care is achievement of the best quality of life for patients and their families. Many aspects of palliative care are also applicable earlier in the course of the illness in conjunction with other treatments.”

That seems to sum it up. Who could not support that statement?

One reason for my participation in the debate is to pay tribute to the hospices that serve my constituency, as many other hon. Members have paid tribute to the hospices that serve their constituencies. My Cleethorpes constituency is served by St Andrew’s hospice, based in Grimsby, and the Lindsey Lodge hospice in Scunthorpe. Both are wonderful organisations that rely on the work of their dedicated and skilled staff and volunteers. I have visited both hospices in the past 18 months; indeed, I visited St Andrew’s only a couple of weeks ago. St Andrew’s also has a children’s unit that serves the whole of the county of Lincolnshire.

I am more familiar with St Andrew’s hospice because my father spent his last weeks in its care and my mother died on the day on which she was due to be transferred to St Andrew’s. My father received care and attention that can only be described as superb. He suffered greatly in the time until he arrived at the hospice, but he seemed to be pain-free during those last few weeks in the hospice. He was in surroundings that allowed me, my mother and other family members to feel reassured that everything possible was being done to give him all the support that was necessary. That was as long ago as 1988. St Andrew’s has progressed enormously since then. It is now in a modern purpose-built building. The drugs and methods of care available have evolved beyond anything that we could have imagined 24 years ago. The advances that are likely to be made in the next 24 years will improve the lives of people who are in their last days beyond measure.

Human life is to be valued. Anything that denies that diminishes society as a whole. I shall conclude by noting one of the contributions made to Lord Mackay’s Select Committee in 2004. It states:

“I would rather die in a country where euthanasia is forbidden but where doctors do know how to look after a dying patient in a humane manner than I would in a country where palliative medicine is ignored but euthanasia can be easily arranged”.

That is the sort of country that I want to preserve.