Care Bill [Lords]

Stuart Andrew Excerpts

Monday 16th December 2013 Commons Chamber

[Stuart Andrew (Pudsey) (Con)]

It is a pleasure to follow the hon. Member for Blaenau Gwent (Nick Smith), who raised a number of serious issues.

Some wide-ranging speeches have been made today, but I shall make a short speech, which will primarily concern the clauses in the Bill that relate to young people and their transition to adult social services. I have spoken on a number of occasions about my experience of working in the hospice movement, particularly the children’s hospice movement, over the last 20 years or so. During that time, I saw some incredible work done by the staff at the hospices, but, more important, I observed the tremendous dedication of the parents and families of the children who worked day and night to ensure that they were given the very best care.

When I joined the last hospice where I worked—Martin House, which at that time served most of Yorkshire—the construction of its new building, Whitby Lodge, had just been completed. The trustees of the charity had identified a real need, the need to look after those who could be described as the “older younger people”. As time has passed, many young people in hospices have been living longer. That is a good thing, but the theme in the children’s hospice became a little bit childish for those who were entering their teens.

In England, more than 40,000 children and young people aged between 0 and 19 currently have long-term health conditions that will eventually end most of their lives, and for which they may require palliative care. Owing to medical advances, more young people with a range of conditions are living into adulthood than ever before. The number has increased by some 30% over 10 years, and the highest rate of increase is among those aged between 16 and 19, who now account for some 4,000—or one in 10—of those aged between 0 and 19 who need palliative care.

When I worked at Hope House children’s hospice in Oswestry, some of the young boys who suffered from Duchenne muscular dystrophy would be lucky to live beyond the age of 18. When I left Martin House, many were living into their late twenties. That is a great thing, of course, but it does mean that we must think about how we can help such young people. The majority of those who may require palliative care have a range of severe disabilities and complex health needs. Contrary to popular belief, cancer represents just under 14% of diagnoses; most of those young people have cognitive impairments, which means that that they lack capacity, and many are cared for over long periods by their parent carers.

Many young people with life-limiting or life-threatening conditions who are more cognitively able struggle to achieve independence and enter education or employment, because plans are not made for them. Those who are unlikely to be cured by treatment are offered palliative care. Palliative care for young people is not simply end-of-life care, but focuses on enhancing the quality of their lives. In their early to mid-teens, young people receive palliative care and other support from children’s services. In their later teens, they start to receive services from adult agencies which assume responsibility at different points after their 16th birthdays. The transition is often complex, and traumatic for families who are already coping with extremely difficult circumstances.

A successful transition needs to address both the transfer of responsibility for young people from children’s to existing adults’ social care, health and education services, and the development of new adult services that are tailored to young people’s additional needs. The transition needs to be planned for years in advance, but, at present, planning is often disjointed and poor. The reduced services and support routinely offered by adult agencies, which are often focused on older people and end-of-life care, come as a distressing shock to many young people and their families. Parents have described the transition as like “standing on the edge of a cliff, about to fall into a black hole”. Poor transitions lead to increased illness, adverse social and educational outcomes, and sometimes even premature death.

Let me ask the Minister some specific questions. Will the statutory guidance on the Bill’s transition clauses which the Department of Health is producing for local authorities ensure that when a child who needs services reaches the age of 14—and is likely to continue to need services as an adult—the local authority initiates advance planning of the care needs that that child will have as an adult? Will it ensure that, from the age of 14 and by the age of 16, every young person who needs services has a five-year rolling transition plan in place, which specifies when his or her needs assessment is likely to take place? Will it ensure that when a child who needs social care reaches the age of 14, the local authority initiates advance planning of the carer’s needs when the child reaches the age of 18? Finally, will it ensure that the full range of services that young people with life-threatening and life-limiting conditions will require as adults—including local authority housing services to help them to live independently—are involved in the transition planning process?

As I have said, it has been my privilege for many years to work with so many inspiring young people and their families. In the hospices where I have worked, I have seen the staff do incredibly hard and great work. They do a tremendous job in trying to help families through the minefield of the care system. I think that the Bill offers us a real opportunity to make things just a little easier for families who are looking after children and young people with life-limiting conditions.

Oral Answers to Questions

Stuart Andrew Excerpts

Tuesday 26th November 2013 Commons Chamber

[Mr Jeremy Hunt]

We are looking at that very closely. We are big supporters of having a free trade deal between the EU and the US, but we do not want to do anything that would affect the fundamental principles, values and practices of the NHS.

[Stuart Andrew (Pudsey) (Con)]

The new review into children’s heart units feels very different, and I am pleased that everything is on the table. However, I was concerned to learn that the task and finish group has decided to meet in private. Given the group’s importance in decision making, and remembering the experience of the Safe and Sustainable review, does my hon. Friend agree that, in the interests of openness and confidence, the group should meet in public?

[Jane Ellison]

My hon. Friend has been a great and sustained champion of that cause in this House and in speaking up for his local hospital and his constituents. NHS England is clear that all substantive decisions on the new review on congenital heart disease will be made by its full board, which meets in public, so there is no question of a major decision being taken in private. With regard to the sub-groups, including the one he mentioned, their papers and minutes are all published, but for practical reasons none of them meets in public, and that is normal practice. However, all major decisions will be taken in public by the full board.

Oral Answers to Questions

Stuart Andrew Excerpts

Tuesday 16th July 2013 Commons Chamber

[Mr Hunt]

If the hon. Lady heard the exchange earlier, she will know that what Robert Francis was recommending was evidence-based tools, not a national minimum staffing level. The reason for that is that the number of nurses needed varies from hospital to hospital and ward to ward. We need to make sure that that happens. In the best hospitals it already does. The system that we have—this was supported by the shadow Health Secretary in his evidence to the Francis review—is not one where the Secretary of State sits behind his desk and dictates the number of nurses required in every hospital. If we did that, we would not be able to run the NHS properly, but we need to make sure that there are proper standards in place, which is why we have a chief inspector of hospitals to make sure that that happens.

[Stuart Andrew (Pudsey) (Con)]

T9. It is right that clinicians should speak out about safety in our hospitals, but does my right hon. Friend agree that now is probably not the right time for clinicians to be speculating in the national media about the safety at Leeds heart unit, given that the Department has yet to release the second phase of the review, as this endless speculation is causing great anxiety to already worried parents?

[Mr Hunt]

I agree with my hon. Friend. He has campaigned very honourably and sensibly for children’s heart services at Leeds. This is not a time for speculation. We will announce this month what the new process will be for resolving Safe and Sustainable. He and I both want this to happen as quickly as possible to remove that uncertainty. Also, we have to find a way of making sure that the data are solid and that we can trust them.

Complex Regional Pain Syndrome

Stuart Andrew Excerpts

Tuesday 9th July 2013 Westminster Hall

[Iain Stewart]

I have much sympathy with what the hon. Gentleman says, and if he bears with me, I will address training and research funding a little later.

The NHS Choices website sets out the quality of care and treatment that CRPS sufferers should receive due to the complex nature of the condition. My constituent should have been provided with a care team comprising a physiotherapist, an occupational therapist, a neurologist, a psychologist, a social worker and a pain relief specialist. He informed me that he has not received such care, as most health professionals whom he has encountered do not even know the condition’s acronym.

That leads me to my principal argument. If NHS clinicians do not sufficiently understand the condition, how will they be able to diagnose it properly and ensure that patients are adequately treated and cared for? The NHS Choices website says that it is hard to estimate exactly how common CRPS is because many cases go undiagnosed or misdiagnosed. I think the hon. Gentleman was referring to that point.

My constituent contends that possibly 250,000 people in England have not been properly diagnosed. He is understandably impassioned about the issue and has been carrying out his own research using American sources—it appears more research is being conducted into the condition in America.

From my own research, I learned from one study that as many as one in 3,800 people in England may be affected by CRPS. Therefore, going by the 2011 census estimates, 14,000 people could either have been misdiagnosed or remain undiagnosed. Although that might appear to be a small number by comparison with my constituent’s estimate, it does not diminish the issue’s importance.

The core principles of the NHS state that good health care should meet the needs of everyone and should be based on clinical need. Kevin Scardifield is unable to do the everyday things that other people take for granted. He was a police officer before the onset of the condition—a profession he greatly loved but had to give up. So debilitating is the condition that, by the middle of last year, he had been able to leave the house only six times, which was just for a few yards to the GP.

I am sure that Members can appreciate why this is such an important issue and why Kevin Scardifield has been campaigning hard for proper diagnosis and treatment. Since he made me aware of the condition, I have made a number of representations to the Department of Health, the local hospital, the primary care trust—now the clinical commissioning groups—and even the Department for Work and Pensions.

I am grateful to the Minister and his predecessor, the right hon. Member for Sutton and Cheam (Paul Burstow), for their replies to my constituent’s concerns when I brought them to their attention. Had my constituent felt that his concerns had been fully addressed, however, we would not be having this debate, so if the Minister will forgive me, I will raise a number of specific issues. First, as I have mentioned, people are either being misdiagnosed or remain undiagnosed because NHS clinicians do not appear to have sufficient awareness of the condition.

[Stuart Andrew (Pudsey) (Con)]

I congratulate my hon. Friend on raising the issue. Although I take an interest in health issues, CRPS is new to my attention. Only today, I was contacted by a lady from Leeds who is a sufferer, and listening to her story was very harrowing. Is my hon. Friend surprised, as I am, that there is only one specialist centre in the UK? That centre is in Bath, which is a long way from many places. If CRPS is diagnosed early, there is a high chance of it going into remission, which would be great for the NHS and, more importantly, for the patients involved.

[Iain Stewart]

My hon. Friend makes an important point, and I suspect that if we spoke to all our colleagues we would find that they, too, have been contacted by constituents with this condition. One of the points that I will make in a few moments is on the need for greater research and specialist services, so that the types of benefit that he rightly describes can be identified and delivered.

Secondly, the number of people diagnosed with the condition is unknown. Indeed, the Department of Health has informed me that it does not hold such records. My constituent informs me that, in 2010, he was told by NHS Direct that just over 11,000 people had been diagnosed in the United Kingdom. In 2012, he came across some information in the CRPS guidelines prepared by the Royal College of Physicians that quoted research suggesting a higher incidence of CRPS in Europe. On the back of that, he again contacted NHS Direct, and this time he was informed that it had been ordered to stop keeping records and to delete existing ones, as that responsibility would be undertaken by the Office for National Statistics. The ONS, however, replied that no such responsibility had been passed to it. Will the Minister clarify that issue and assure me that there is a strategy in place adequately to capture the number of people being diagnosed with CRPS? Will he also look into claims that specialists are failing to highlight the seriousness of the condition, particularly its potentially degenerative nature?

Thirdly, there does not seem to be an agreed pathway within the NHS for the treatment and care of those diagnosed with the condition. If there is, it was not reflected in the care that my constituent received. Will the Minister ensure that all NHS trusts and clinical commissioning groups follow the guidelines?

Fourthly, compared with the United States and other European countries, we are not doing enough to research the condition with a view to finding a cure and ensuring an improved quality of life for CRPS sufferers. While preparing for this debate, I observed that there was more information on the condition on US-based websites than on UK-based ones. I have also been unable to find UK charities or support groups for CRPS. Everyone can be proud of the fact that since the start of modern clinical trials, 39,179 trials have been made or are in progress to find a cure for cancer. The UK has carried out about 2,299 of them. The UK Charity Commission has 976 cancer charities on record, and the NHS spent more than £375 million between 2008 and 2012 on researching a cure for cancer. Clearly, that is a wonderful amount of research, but during the same period, only 76 trials on CRPS have been conducted worldwide. Holland, with a population of just over 16.5 million, has carried out three trials, and Switzerland, with a population of 8 million, has carried out two. The UK has a population of more than 60 million, yet I have been unable to locate a record of our carrying out any trials.

In addition, the NHS does not appear to have invested much in researching CRPS. I understand that one project was carried out last year in Bath, to which my hon. Friend the Member for Pudsey (Stuart Andrew) referred, but it was not aimed specifically at finding a cure, and it was funded by an American charity. Will the Minister look into funding for more UK research into the condition? Specifically, will he consider my constituent’s suggestion that a post be created within the Department of Health for a CRPS officer to liaise with specialist clinics around the world to collect, collate and disseminate papers and studies on the condition? My constituent explains that it would prove useful, as it was not until 19 years after the US first stated that guanethidine blocks were ineffective on RSD sufferers that our own specialists came to the same conclusion.

I hope that the Minister will address those matters when he replies, and I hope that this debate will help draw attention to this important issue, so that more people are properly diagnosed and adequately treated. I also hope that I have been able to do justice to the needs of sufferers such as my constituent. May I suggest that the Minister find time at some point in future to meet them, so that he can properly understand the sheer pain and agony that they face?

Children’s Heart Surgery

Stuart Andrew Excerpts

Wednesday 12th June 2013 Commons Chamber

[Mr Hunt]

I think we have been having a constructive discussion about an extremely difficult issue, in which I hope I have spoken for the whole House in saying that there are things that we need to learn on all sides, as the earliest signs went back as far as 1984 and still, in 2013, we have not been able to make the progress we should. It is important that we maintain that bipartisan approach, because at the end of this process there will be difficult decisions to make and we need to maintain public confidence that we are thinking about this in a non-party-political way.

[Stuart Andrew (Pudsey) (Con)]

I think I can hear the cheers in Leeds as I speak. May I put on the record my thanks to the IRP and to my right hon. Friend the Secretary of State for listening to our concerns in a very difficult situation? These findings clearly vindicate what we have been saying all along, but as we move forward will he agree to meet me and clinicians to maximise confidence in the future review? Will he assure us that co-location of services, accessibility and patient experience are paramount and that all units will have the same scrutiny as the one in Leeds has undergone? May I invite him to visit the unit in Leeds, so that he can meet the patients, families and staff with whom it has been my privilege to work?

[Mr Hunt]

I congratulate my hon. Friend on campaigning for children’s heart surgery in Leeds in an exemplary way, and he deserves huge credit for the responsible approach he has taken throughout. I would be delighted to meet him and clinicians from Leeds. Many things need to be learned, but his points about the importance of the patient experience, of clinical outcomes and of an impartial process in site selection, which is at the heart of the concerns people had about this process, are ones we need to reflect on very hard indeed.

Oral Answers to Questions

Stuart Andrew Excerpts

Tuesday 11th June 2013 Commons Chamber

[Dr Poulter]

The hon. Gentleman is absolutely right to highlight that there has, in the past, sometimes been unacceptable variation in the quality of post-natal care. That is why we are increasing the number of midwives and have done so by nearly 1,400, and why we are putting money and effort into increasing the number of health visitors, who play a vital role in supporting mums, babies and families in securing that important bond, and in supporting mums so that they get the right help when they suffer from post-natal depression.

[Stuart Andrew (Pudsey) (Con)]

3. What plans he has for the future of children’s heart surgery provision in Yorkshire and the Humber.

[The Secretary of State for Health (Mr Jeremy Hunt)]

I asked the Independent Reconfiguration Panel to undertake a full review of the “Safe and Sustainable” review of children’s congenital heart services. I have received and am currently considering that advice, and will make my decision known shortly—perhaps very shortly.

[Stuart Andrew]

I am grateful for that answer. Will my right hon. Friend accept that the Leeds unit has undergone the greatest scrutiny of any of the units included in the review, and has met all the standards required? Will he therefore assure patients, families and staff that both he and NHS England have every confidence in the performance and standards of the Leeds unit? If we are to have informed choices on the future of heart units, surely all units must be subject to the same scrutiny.

[Mr Hunt]

First, I want to congratulate my hon. Friend on the sustained campaigning that he has done for that children’s heart unit, and on the very responsible way that he has conducted himself in what has been an extremely difficult campaign for the people of Leeds. I have full confidence in children’s heart surgery at Leeds; I know that the Leeds unit does an excellent job. He will understand, as I do, that when there are safety concerns, they have to be investigated, but I am delighted that those issues have been resolved, and that surgery is continuing.

Heart Surgery (Leeds)

Stuart Andrew Excerpts

Monday 15th April 2013 Commons Chamber

[Stuart Andrew (Pudsey) (Con)]

(Urgent Question): To ask my right hon. Friend the Secretary of State for Health if he will make a statement on Leeds children’s heart surgery unit.

[The Secretary of State for Health (Mr Jeremy Hunt)]

Following the deaths of 30 to 35 children at the Bristol royal infirmary between 1991 and 1995 and the subsequent inquiry, children’s heart surgery is rightly the subject of great public concern.

With respect to Leeds general infirmary, there are three issues that the House will want to be updated on: was it right to suspend children’s heart services at Leeds on 28 March; was the decision handled in the best way possible; and, given his public comments, is it appropriate for Professor Sir Roger Boyle to have a continuing role in the Safe and Sustainable review of children’s heart surgery?

First, was the right decision made? The answer is categorically yes. The principle of “first do no harm” must run through the very heart of the NHS. If there is evidence that patient safety is at risk, it is absolutely right that the NHS acts quickly and decisively to prevent harm to patients. However difficult or controversial, we must never repeat the mistakes made at both Mid Staffs and Bristol, where arguments over the quality of data prevented action that could have saved patients’ lives.

Secondly, was the decision handled properly? On 26 and 27 March, Sir Bruce Keogh, NHS England’s medical director, was given a range of critical information about the quality of care at Leeds: statistical data that indicated higher than expected mortality rates; concerns about staffing rotas; and further concerns from parents and a national charity about the way the most complex cases were referred. With the agreement of the LGI, Sir Bruce took the entirely appropriate decision to suspend children’s heart surgery while further investigations were made. The families were informed on the day the decision was taken to suspend services, 28 March.

On 29 March—Good Friday—the day that decision became public, I spoke with the right hon. Member for Leeds Central (Hilary Benn) and my hon. Friends the Members for Pudsey (Stuart Andrew) and for Leeds North West (Greg Mulholland) to inform them of the situation. My conclusion is that, on the basis of the information available to him, Sir Bruce behaved entirely properly. He was also right to authorise the restarting of surgery from 10 April for low-risk patients on the basis of more complete data and assurances from the trust.

The third question is whether, in the light of his recent comments, Professor Sir Roger Boyle can have a continuing role in the Safe and Sustainable process. Sir Roger is one of our leading heart surgeons. He did the right thing in informing Sir Bruce of his concerns over Leeds’ mortality data. He has also played an important role as an adviser to the Safe and Sustainable review of children’s heart services. However, it is the view of Sir Bruce Keogh, with which I concur fully, that Sir Roger’s comments to the media on 11 April could be seen as prejudging any future conclusions of that review. It is therefore right that Sir Roger plays no further role in its deliberations.

--- Later in debate ---

[Stuart Andrew]

I am grateful to my right hon. Friend for his answers. No one would disagree with the point that information that is provided about the safety of a unit should be investigated. However, the quality of the information and the source of the complaints raise serious questions about the proportionality of the action that was taken and, more importantly, about the motives of the complainants. Sir Roger Boyle was a key adviser to the Safe and Sustainable review, which proposed an illogical outcome for northern England. His recent actions and comments surely prove that the decision to close the Leeds unit was predetermined.

Sir Roger leaked data that were unverified to argue for the suspension of surgery—an action that was described as “appalling” by their author. The information was inaccurate and, when corrected, demonstrated that the Leeds unit was safe. In fact, it showed that it is in a similar position to the units at Guy’s and Alder Hey. Why did Sir Roger not recommend the suspension of surgery at those units? Is it because those are the ones that he and the Safe and Sustainable review recommended as designated centres?

Furthermore, on Friday, despite detailed scrutiny that proved that Leeds was safe, Sir Roger claimed that it was on the edge of acceptability and that he would not send his daughter there. Those comments demonstrated a clear bias against Leeds and were irresponsible in respect of parents whose children are facing surgery. In addition, one of the whistleblowers has been identified as a surgeon from the Newcastle unit, which is another example of vested interests.

The suspension of surgery and Sir Roger’s comments have caused huge anxiety and concern among patients and staff, and have hurt the reputation of the hospital, which it has taken years to build. I therefore ask the following questions of my right hon. Friend.

How can we have faith in the Safe and Sustainable review, given that its key adviser has behaved in such an appalling and biased manner? Despite the fact that he will no longer take any part in the review, the decisions remain. Does this matter not prove that Sir Roger acted in a predetermined manner? Is it not vital to put the patient’s interests first, rather than NHS politics? Does my right hon. Friend agree that Leeds has been treated disproportionately when compared with other units that have similar figures? Is he aware that there are reports of surgeons being anxious about providing data for fear of reprisals? Is there not an urgent need for the Independent Reconfiguration Panel to report to resolve the uncertainty that exists across the country with regard to children’s heart surgery? Is it not time to give serious consideration to the proposal that both Leeds and Newcastle should stay open, which is supported by clinicians and patients as it is in their best interests? Finally, will he pay tribute to the staff and patients at Leeds, who have acted with great dignity in the face of hostile criticism?

[Mr Hunt]

I do pay tribute to the staff at Leeds and to the families of patients. I recognise that this is an issue of huge concern. As my hon. Friend rightly says, they have behaved with great dignity in a difficult situation. I also pay tribute to him for the responsible way in which he has behaved in this difficult situation, as have many Leeds MPs.

My hon. Friend will understand, given that the NHS nationally was provided with data that suggested that mortality could be up to 2.75 times greater at that unit and given that there was a potentially busy holiday weekend ahead, when it did not know how complex the cases would be and when there were locums on the staff rota who may or may not have been up to the standard of the permanent staff, that Professor Sir Bruce Keogh had genuine concerns that led to his decision. But I hope the fact that surgery was restarted on 10 April will assuage my hon. Friend’s worry that the initial decision was linked to the Safe and Sustainable review—it was not; it was a concern about patient safety and because that concern has been addressed, surgery has restarted.

There were, however, issues about the quality of the data, which at least in part was because the hospital was not supplying data properly in the way it needed to. That was one reason why the mortality data were not as accurate and good as they should have been. Although I entirely agree that patient safety must always come first, and not NHS or national politics or whatever it may be, that also means that sometimes difficult decisions have to be taken. What happened at Mid Staffs, where we had a big argument about data that meant nothing happened for too long, and what happened originally at Bristol, where up to 35 children may have lost their lives, is a warning about the dangers of inaction. On this occasion, I think that overall the NHS got it right.

Suicide Prevention

Stuart Andrew Excerpts

Wednesday 6th February 2013 Commons Chamber

[Stuart Andrew (Pudsey) (Con)]

I am grateful for the opportunity to take part in the debate. I pay tribute to the hon. Member for South Antrim (Dr McCrea) and all Democratic Unionist party Members for bringing this important debate to the Floor of the House. I am sure they were tempted to debate many other issues, but it is important that we discuss suicide prevention, which is a crucial but difficult issue.

Yesterday, I spoke of some of the most difficult times in my life. I was lucky to have the support of a loving family and great friends, but many unfortunately do not have that. Before being elected, I worked in the hospice movement. In that time, I got to know a lot of the patients well, and, sadly, death became a norm—I did not want to use that word, but I am sure hon. Members understand what I am getting at. Bereavement is always difficult, but suicide bereavement is a different type of bereavement altogether.

Sadly, I say that from personal experience. When I was in the sixth form, I remember vividly walking in and a friend saying to me, “Have you heard about that boy?”—I will not mention his name. He had taken his own life because he had been bullied at school. I remember all the students sitting in the common room in complete and utter shock. All I could think about were the questions going around in my head. What could I have done? Why did I not spot that he was in that difficult place? If I am honest, those questions still haunt me today. In more recent times—since I have been elected as a Member of Parliament—there was the very sad case in my constituency of a father who killed his entire family and then himself.

The suicides I have seen and experienced have had a tremendous effect on the people who are left behind. That is why the debate is important, but more importantly we should act and not just talk about suicide. We must also start right at the beginning and change people’s attitudes. How many times have hon. Members been on a train that has been delayed because somebody has taken their life, and the instinct of some passengers is to moan about the delay, forgetting that somebody has lost their life?

Hon. Members have spoken a lot about attitudes to mental health. I am very proud of the fact that a lot of work has been done in the Chamber to address that. It is a good start to try and take away that stigma. I pay particular tribute to my hon. Friend the Member for Broxbourne (Mr Walker) and the hon. Member for North Durham (Mr Jones), who have spoken openly about their own personal battles. As hon. Members have said, however, suicide is a much wider subject than just mental health; it can be about finance, careers or family breakdown. It is important that we address all those issues, which is why I welcome the fact that the suicide prevention strategy is in place. It is important that the strategy is not just a piece of paper; it has to be backed up by action, and it is good to see that happening. Crucially, it is partly about identifying the risks.

[Andrew Stephenson (Pendle) (Con)]

I agree with what my hon. Friend is saying. In January, suicide-proof fencing was installed at a multi-storey car park in Nelson in my constituency, from which eight people have died in the past 10 years and a further 18 people have had to be talked down by police. I raised this issue on the Floor of the House in October 2010 in an Adjournment debate led by the hon. Member for Bridgend (Mrs Moon), yet it still took the car park owners years to act. In addition to what my hon. Friend is saying, does he agree that businesses have a key role to play in identifying risks?

[Stuart Andrew]

I am grateful to my hon. Friend for that intervention. He is absolutely right: we need to do everything we can—talking to individuals themselves or lessening the risks—to identify those areas. A lot of work has been done in the prison system to try to improve cells to reduce risks. Businesses also have an important role to play.

It is important that the strategy targets specific groups who we know may be vulnerable. Targeting young people will be important, because we want to change attitudes in the future. We also have to look at why so many young men are committing suicide. We have been talking about mental health, but let us face it: men are not very good at talking, and that is part of the problem. As we move into the digital age and we all spend so much time on our computers, being used to talking with others will lessen over time. I fear that we will have a generation who will be even worse than the current one in talking about their problems.

Improving access to “talking therapies”, the strategy’s four-year plan, and expanding it to all ages and different groups, is important. From my own experience, I know that we need to ensure that there is as much work on school intervention as possible to deal with bullying and violence. We must allow people to talk about the threats they feel, whether they are sexual abuse or bullying at home. We also have to remove barriers for people who are disabled, or who have mental health or other long-term conditions. We want to make them feel that they can play a full role in our society and do not become isolated.

Areas that require emphasis have been highlighted by a constituent of mine. I pay tribute to Mike Bush. He and I are unlikely friends. He describes himself as “red socialist”, but he and I have become very good friends and I have a huge amount of respect for him. He has done tremendous work in this field and is an active member of the all-party parliamentary group on suicide and self-harm prevention. On many occasions, he has highlighted the importance of working with bereaved families. I welcome the fact that the strategy gives greater prominence to measures that support those families; being there and helping them to cope with a family member whom they are worried might commit suicide, and helping them cope with the aftermath of someone who has committed suicide.

Getting better information through the research that is being offered can only be a good thing, but the emphasis must be on support, and I completely agree with the hon. Member for Bridgend that we need to ensure good national provision. We need to ensure that suicide prevention measures are available in every part of our country. In particular, bereavement support needs a suicide angle to it, because it really is very different. In my time at the hospice, I saw how fragmented bereavement services were around the country, but specific suicide bereavement support is even more fragmented.

I hope that as the strategy develops we will continue to work with the many wonderful organisations we have in this country, many of which have been mentioned today, such as the Samaritans. The APPG is a great start, bringing together a coalition of organisations with a wealth of experience, but it is also important that we listen to family groups that have been through this dreadful experience. What makes Martin House children’s hospice such a wonderful organisation is that it is parent-led. The parents describe the care they need, and that is why it can offer such wonderful support. In the same way, the best strategy for dealing with suicide will come from those families who have experienced it.

We need action on cyber-bullying. Bullying has existed in schools for many years, but it has taken on a different form now. People can be bullied at school, but when they get home it continues through the social networking sites and the computers in their bedrooms. In a sense, these children and young people are suffering from a silent bully. The suicide websites have been touched on. We must do more to close them down completely.

I hope that we can offer further training for organisations and—perhaps—the police in helping them to deliver that bad news. I have had several constituents tell me that they almost felt sorry for the police officer delivering the news because it was so difficult. It is important that these organisations be aware of the wealth of information out there. I am glad that the “Help is at Hand” document has been mentioned, because it is not used enough.

In conclusion, suicide is tragic in every sense: the loneliness of the person doing it, the long bereavement for those left behind, the guilt they suffer for years after and the great risk that they themselves might go on to commit suicide. It is crucial that we face this risk. This debate is just the start: let us now address and act on it.

Leeds Children’s Heart Surgery Unit

Stuart Andrew Excerpts

Tuesday 30th October 2012 Westminster Hall

[Stuart Andrew (Pudsey) (Con)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I am grateful to have a further opportunity—you might wonder why we are taking another chance to raise the issue—to discuss the Leeds children’s heart unit. Given that there is a new ministerial team at the Department of Health—I am delighted to welcome the Under-Secretary of State for Health, my hon. Friend the Member for Broxtowe (Anna Soubry) to her new post—and that the decision on the unit has been referred to the Independent Reconfiguration Panel, it is critical that the independent review gets this right. The issues that we have been raising need to be assessed in great detail by the independent panel.

It is important for us to remind ourselves of the key issues. I want to make it crystal clear at the outset that we have always supported the objective of the review. Of course, we all want the best services for our children, and having fewer specialist centres is a principle that we have never doubted. My grave concern is that the review will fail to meet the objectives, particularly in the north of England, subjecting my constituents and those in Yorkshire and Lincolnshire to a worse service than the one that they currently enjoy. That is why I want to outline our concerns.

First, the review has always made it clear that units need to perform 400 operations or more a year. If that is the agreed standard, we must accept that. However, a survey by PricewaterhouseCoopers showed that the majority of patients who live in east, west and south Yorkshire would not travel to Newcastle. Instead they would go to Liverpool, Birmingham, or, in some cases, even to London. Anyone who knows our area knows that that is instinctively the case. Since the decision was made, adverse weather over the past couple of months has caused huge problems on the A1. Would a parent go there or would they choose less problematic routes? The issue is made clear in the analysis. The independent review document states:

“There was more reluctance amongst members of the public to consider travelling to Newcastle as a centre. If the preference of the parents and the public were factored into assumptions of patient flows, they may have implications for projected levels of activity at – in particular – the Newcastle centre.”

What is the review’s answer to the problem? At the decision-making process meeting—a seven-hour meeting to rubber-stamp a decision that clearly had already been made—it was said that patients preferring centres other than Newcastle would be influenced by referring doctors, with the assumption made that they would be pointed to Newcastle. Frankly, the evidence points to the contrary: all 20 referring clinicians in the Leeds network, whose views were never sought by the Safe and Sustainable review, said that they would not refer patients there for treatment.

In addition, the review argued that if 25% of patients from Leeds, Sheffield, Doncaster and Wakefield chose to go to Newcastle, that unit would perform 403 operations a year, conveniently just over the target of 400. That also assumes that 100% of patients in the other remaining postcodes, including Hull and Harrogate, would go to Newcastle. Newcastle can only reach the 400 figure if all the assumptions—that 25% will go from south and west Yorkshire, that clinicians will refer, and that 100% in Harrogate, Hull and elsewhere would use the centre—are correct, but there is no evidence to support such assumptions.

Given the importance of the 400 figure, it is staggering that it has been reached on the basis of assumptions. I know my hon. Friend the Minister was a barrister before entering the House. I wonder how the court would have reacted if she had based her defence or her prosecution on assumptions. That is why I believe the review is flawed. If we are going to change, it must be for a much better service.

That brings me to the issue of co-location. The foundation of the review was the inquiry at Bristol, and ensuring that such events never happen again is crucial. A key recommendation of the inquiry was to have all paediatric services under one roof. The British Congenital Cardiac Association has stated:

“It is important that the centres designated to provide paediatric cardiac surgery must be equipped to deal with all of the needs of increasingly complex patients. For these services at each centre to remain sustainable in the long term, co-location of key clinical services on one site is essential.”

I completely agree with that statement. Indeed, Professor Sir Ian Kennedy, in his report following the Bristol inquiry, stated in recommendation 178:

“Children’s acute hospital services should ideally be located in a children’s hospital, which should be physically as close as possible to an acute general hospital. This should be the preferred model for the future.”

Yet despite Sir Ian’s assessment panel describing the location of key services on a single site as optimal, Sir Ian accepted a watered-down definition of co-location, which allowed Newcastle to be described as a co-located service, and that led to the decision to close Leeds, despite the Paediatric Intensive Care Society’s assertion that it

“would dismiss any suggestion that a service located on another hospital within the same city can be regarded as being equivalent to a service located on the same hospital site.”

What has caused Sir Ian Kennedy to change his mind? Anyone visiting the Leeds unit will know that it is a wonderful, integrated unit. It has all the services that are needed for children with complex and multiple needs. They need paediatricians there with other specialities. On my several visits to that unit, on each occasion I have seen paediatricians coming to help patients with complex needs.

[Philip Davies (Shipley) (Con)]

My hon. Friend has led this campaign in Parliament with his customary charm and tenacity. As ever, he is making an excellent case. The national health service is paid for by the public for the benefit of the public. Ultimately, the services that we provide should be the ones that the public want. MPs from our region, from across the parties, are here today, and it is clear that the people in Yorkshire have confidence in the unit, want it to continue and believe it will offer the best possible treatment. Should that not be one of the most important factors that the Government bear in mind?

--- Later in debate ---

[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.

[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.

[Hilary Benn (Leeds Central) (Lab)]

I echo other Members’ compliments about the force of the hon. Gentleman’s case. The review, if it is about anything, must be about the right clinical outcomes for children. That is why we are all here. We are all so passionate about the Leeds children’s heart surgery unit, which I have the privilege to represent. Will he confirm that despite the impression that is being given in some quarters, no assessment of the relative clinical effectiveness of the units considered in the review has been undertaken? Does he agree that the independent review must do that, as we all believe that it would lead to the decision being overturned?

[Stuart Andrew]

The right hon. Gentleman is absolutely right. He makes a clever and important point, because that is the foundation of the decision, and the information either does not exist or is incorrect. I want a root-and-branch review of the decision and all the information that was at the disposal of the Safe and Sustainable review team. I hope we can get an assurance today that the panel will do that.

There are further problems with the decision-making process. The joint committee of primary care trusts is still not disclosing information requested by the joint health and overview scrutiny committee in our area, including the agendas, minutes and reports of several meetings material to the JCPCT decision. There is also no evidence that the joint health and overview scrutiny committee’s report was even discussed by the JCPCT. The JCPCT has refused to disclose the breakdown of the Kennedy scores awarded to each children’s heart surgery unit by the panel. The value of the total scores, which are the supposed measure of quality, could neither be understood nor scrutinised.

I think we all believe that the JCPCT has misused the Kennedy scores. The JCPCT requested not to be shown the breakdown of the Kennedy scores, which raises many questions about the JCPCT’s ability to make an informed decision. The Kennedy scores were not prepared for the purposes of comparing one centre with another, yet a ranking of the units by total score was published. The scores were misused as indicators of quality, even though the scores did not assess units on what most of us would regard as measures of quality, such as clinical effectiveness, safety and patient experience.

The total unit score was given as 401 for Leeds and 425 for Newcastle. Those scores were published with the independent expert panel’s report in 2010. According to the first breakdown of the total scores, however, which was only released after the JCPCT made its decision, the Leeds unit gets 414 points and the Newcastle unit gets 421 points. Despite the enormity of the review, a basic mistake appears to have been made in the calculation. That matters because, in the eyes of the JCPCT, which saw only total scores, the advantage of the Newcastle unit was more than trebled from seven points to 24. When that was pointed out to the JCPCT, a second set of sub-scores was published that still did not add up to the original scores of 401 for Leeds and 425 for Newcastle; it stated that the Leeds unit outscored Newcastle on the core clinical standards used by Professor Kennedy by 347 points to 336. On care quality, Leeds is ahead; Newcastle outscores Leeds only because of the addition of leadership and vision standards, which are non-clinical standards covering IT and business strategy, working practices, and so on, that were developed by commissioners, not clinicians.

When the fact that Leeds outscores Newcastle on core clinical standards was pointed out to the JCPCT by the Yorkshire and Humber joint health and overview scrutiny committee, a third set of sub-scores was published, with the dubious claim that they were the raw Kennedy scores. The scores did add up to the original 401 for Leeds and 425 for Newcastle, but, mystifyingly, they now put Newcastle ahead of Leeds on core clinical standards. It is unclear which of those different sets of scores was used by the JCPCT because they give such different impressions.

The Kennedy scores were subject to a weighting system that disproportionately emphasised certain aspects of the assessment in a way that produced misleading results when used in a comparative process. No explanation was given for the way the weightings were worked out. I could address further issues, but I am aware that other hon. Members want to take part in this debate.

We suggested that the JCPCT’s decision be implemented elsewhere, but that in north-east England, both Leeds and Newcastle remain open and that the decision be delayed until April 2014. That would give an opportunity for patient choice and for parents to consider which centre they want to use, as is their constitutional right. By the end of that period, each centre would have to demonstrate that it is fully compliant with all the standards set by the Safe and Sustainable review. The judicial action brought against the JCPCT by Save Our Surgery might then cease; that would avoid the risk of sinking the review in its entirety. Leeds and Newcastle would have the opportunity to demonstrate their compliance with Safe and Sustainable standards. Less controversial decisions taken by the JCPCT could proceed elsewhere in the country, and the Government would be shown to be listening to the concerns of patients. That would give a clear message from the Department of Health that patient choice comes ahead of professional convenience. We made that suggestion, and it was rejected out of hand in no time at all. It is a sensible proposal for a solution that would allow us the very best services for our children and young people, as evidenced by where people go and what services they want.

Finally, I attended last week’s Westminster Hall debate on the Leicester unit. My hon. and learned Friend the Member for Harborough (Sir Edward Garnier) summed up the debate well. There is no point in my trying to come up with a fancier conclusion, so I will do him the honour of quoting what he said:

“The House does itself no great service if it shilly-shallies around process and avoids the question. As Members of Parliament, we must ensure that the question is put…The Secretary of State has the levers of power in this question and he must pull them—he must exercise them—and make a decision…I do not care who made the decision or how the dainty route was created to get to it. We all know that the current decision is wrong and needs to be dealt with.”—[Official Report, 22 October 2012; Vol. 551, c. 188WH.]

[Several hon. Members]

rose—

Children’s Cardiac Surgery (Glenfield)

Stuart Andrew 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.

--- Later in debate ---

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

It is a pleasure to serve under your chairmanship, Mr Hollobone. I congratulate my hon. and learned Friend the Member for Harborough (Sir Edward Garnier) on securing the debate and other Members on all the contributions that we have heard. I pay tribute to all Members who have attended today, as well as those who have spoken. My hon. Friend the Member for Pudsey (Stuart Andrew) attended the debate but, unusually perhaps, has not made a speech, although we have not been discussing the hospital for which he has campaigned so hard.

I pay tribute to all Members who have spoken in numerous debates in the House, written letters to Ministers, met and conferred with local groups and experts and spoken at length to their ordinary constituents. As a result, we have heard a moving story from the hon. Member for Leicester West (Liz Kendall) about the services offered at Glenfield, and there are many more stories to be told about children’s heart services centres throughout England. All such Members have campaigned locally to have decisions overturned or reviewed in some way, or to ensure that the right decisions have been made on the right basis. They have brought such arguments and their campaigns to the House, as they should do, because each of them is doing their job as a first-class, local constituency MP by bringing important issues to this place.

I also pay tribute to great cross-party work, which my hon. and learned Friend the Member for Harborough mentioned, both in Parliament and locally. Forgive me for speaking not only as a Minister but with my other cap on as the Member of Parliament for Broxtowe. On my local television service, I have seen and witnessed such cross-party work, which is to be commended; such issues are not party political and certainly nothing to do with any alleged cuts. This is about how we ensure that our children and babies get the very best heart surgery services that we can give them.

I must pick out my hon. Friend the Member for Loughborough (Nicky Morgan) and the hon. Member for Leicester West, who together have spearheaded the campaign, but I also pay tribute to all the work and effort of the hon. Member for Leicester South (Jonathan Ashworth), who joined them at the meetings. Everyone involved in the process up to the decision of the joint committee of primary care trusts has been motivated by the very highest of intentions to ensure that our children and babies receive the very finest heart surgery services that we can provide, and that those services are sustainable.

I will deal with as many of the points that have been raised today as I can. As I said at the outset, hon. Members should make and have made their points so that they can be recorded—not just so that their constituents can see how they have advanced the argument, but so that those who, in turn, must look at the decisions that have been made and consider the arguments can see how important these matters are, because they have been raised in Parliament by local Members.

I turn to what has happened today and what is, in some respects, the nub of the debate, which has been very good. As many hon. Members know, councils have a right to challenge the JCPCT’s decision, and today the Secretary of State has agreed that the Independent Reconfiguration Panel should conduct a full review. I will come to what that means in a moment. He has asked the panel to report back by the end of February—my hon. Friend the Member for North West Leicestershire (Andrew Bridgen) was worried about the time factor—or, and this may concern my hon. Friend, after conclusion of the legal proceedings brought by a Leeds-based charity, which may delay things, although I hope not.

The review will consider whether the proposals for change under the Safe and Sustainable review of children’s congenital heart services will enable the provision of safe, sustainable and accessible services, and if not, why not. The panel’s review will also be able to consider how the JCPCT made its decisions and—hon. Members may think that this is the most important point—the implications of those decisions for other services.

The Independent Reconfiguration Panel today received instruction from the Secretary of State and will now begin to consider how to constitute its review. It is, of course, a matter for the panel to decide how to conduct that review. It is an independent body, but I make it clear that it will look at all the decisions and—for many hon. Members this is most important—at the implications of those decisions, which includes the implications for the unit at Glenfield.

[Stuart Andrew]

rose—

[Liz Kendall]

rose—

[Anna Soubry]

I shall give way to my right hon. Friend the Member for Pudsey, then to the hon. Member for Leicester West.

[Stuart Andrew]

I thank my hon. Friend for the promotion. I am grateful that there has also been cross-party support in the campaign to keep the unit in Leeds open. I want absolute clarification on the IRP. Will she assure me that it will consider the whole decision-making process, including the initial assessments and all the data that were submitted? That is where many of us believe there to be inaccuracies, which have brought about the wrong decision.

[Anna Soubry]

I am grateful to my hon. Friend. It will be for the IRP to decide the full extent of its review of all the decisions that have been made, but the points that he has made here and in various letters will no doubt be put to it for consideration. I am told that, so far, it has not had a formal request from Leeds city council’s overview and scrutiny committee, and perhaps he can prevail on the committee to make that submission as a matter of urgency, so that we can all be absolutely sure that the review will be concluded by the end of February, and that there will be as few delays as possible.