Independent Voices - Closing children's heart surgery units? Time to rethink your NHS 'strategy' Mr Hunt

These units do a tremendously important job – let’s not forget that

By: MANUEL BARCIA 23 Jan 2013

A few days ago I took a couple of friends who were visiting us to a restaurant in Leeds.

As soon as we sat, and even before I had an opportunity to look at the menu, I noticed a small SOS-Save our Surgery booklet on my table. The reading that followed left me in disbelief and almost gave me a bad stomach ache.

Apparently, in his wisdom our Health Secretary and his escort of bureaucrats in charge of restructuring the NHS have come to the conclusion that the whole of Yorkshire and the Humber, the region with the fastest population growth in England, with around 5.3 millioninhabitants, does not really need a Children’s Heart Surgery unit. Yes, you read that right, a Children’s Heart Surgery unit. Talking about the weakest link getting the hit for the messing up of the government and the banks.

Apparently, while doing their restructuring “thinking” (and I put thinking within inverted commas, because Neanderthals would probably generate brighter and more logical ideas) Government bureaucrats did not consider the gold standards given to the Children’s Heart Surgery unit based at the Leeds General Infirmary. To them a unit that offers over 400 children heart surgeries a year would be better closed, and the parents of these children, who already have to deal with the despair of having a very ill child, would be better off travelling for hundreds of miles to the nearest units, in Newcastle, Birmingham or Liverpool.

No wonder a number of demonstrations, a Facebook page with thousands of likes, and a well-organised campaign based around the site have been put in march. Its organisers are fighting the government in court and have now been granted a judicial review of their case next month.

The support that the campaign is gaining is notable. Only a few days ago the Archbishop of York, Dr John Sentamu joined in and called for the Government to reconsider their priorities when it comes to implementing cuts. He said: “Closing the specialist heart unit at Leeds will have a devastating effect on so many people. It would be terrible news for people across Yorkshire.” Others, including MPs Andrew Jones and Hilary Benn have also joined the fight and questioned the decision of the aforementioned closure.

Of course, the LGI unit is not the only one at risk of being shut down. Three other children’s heart surgeries are penned to suffer the same fate. The unit at the world-leading Royal Brompton Hospital in London being one of them.

The tragic part of this story is, of course, that staff working at these units are now doing their very delicate jobs under pressure, and funds raised through charity efforts that could and should be spent on medical supplies and care, are instead being wasted on a judicial review, paying lawyers and legal fees.

It is time for Mr Hunt to finish this uncertainty once and for all. The LGI Children’s Heart Surgery unit does a tremendously important job for the whole of Yorkshire and the Humber, and as such it should be not only kept open, but backed as a priority by the Government. I cannot imagine of anything else that should constitute a priority over our children’s health. Let’s hope Mr Hunt and his staff eventually come to think the same.

Anne Keatley-Clarke, Chief Executive of the Children’s Heart Federation commented, “CHF, other national heart charities and the associations of medial professionals support the implementation of these standards because we believe strongly that they will ensure better quality care. This review was a long-awaited clinician led review, which started with the development of new care standards to ensure the highest quality of care and is certainly not part of a cost-cutting exercise. Whilst surgery may cease, other services are planned to continue at cardiology centres and through planned regional networks, more services should be provided even closer to home”.


Comments as at: 09:33 on 25 January 2013

I am myself a parent of a child with a Heart Condition, and am VERY GRATEFUL for the hard work of the LGI. The unit needs to stay open, i don`t agree with the fact that babies should be transported to a hospital hundreds of miles away, i think it`s absolutely ludicrous that the government are expecting seriously ill babies and children to be travelling. They certainly haven`t thought of all the pressure it`s going to put on families when thay have a sick child in another city. I myself know a doctor that works at Newcastle hospital and lives in leeds, and when the weather was bad on Monday, he couldn’t `t get to work. Have the government thought about this???

This article is either deeply dishonest or woefully ill-informed. And quite possibly both.I want to expose your biggest lie, because it’s important to be clear about this; the review which concluded that England should have fewer, larger surgical centres has absolutely nothing to do with government cuts. It was first proposed by the 11 paediatric cardiac surgical centres themselves in 2006, and the Royal College of Surgeons concurred with the view a year later. The Safe and Sustainable review was set up in 2008, before any austerity measures. Sharon Cheng, who is leading the Save Our Surgery campaign, is on record as agreeing that the status quo of 10 centres is neither safe nor sustainable.The notion that fewer, larger centres is necessary to improve care is also supported by the Royal College of Nursing, the British Heart Foundation, the Royal College of Paediatrics and Child Health, the Society for Cardiothoracic Surgery and the British Congenital Cardiac Association, amongst many other national organisations. The reasoning behind this is very straightforward, most importantly surgical outcomes will be better. That means that less babies will die, and survivors will enjoy a better quality of life. This is the ‘Neanderthal logic’ that you cite. All of this is clearly laid out here:

Repeating the word bureaucrats over and over is childish and unhelpful. There is virtually no disagreement with the idea that England needs bigger surgical centres with more surgeons doing more operations and sharing skills. Of course, any of the surgical centres recommended for closure will disagree that they should be the one to close. These decisions were made over years of deliberation, with one of the largest public consultations in NHS history. It considered numerous factors, outlined in the above link. There are genuine concerns about the manner in which these factors were considered and weighted from those who believe that LGI should remain a paediatric heart surgical centre, none of which are alluded to in your piece.

Your article adds precisely zero value to the debate, and can fairy be summarised as disingenuous scare-mongering.

Yeah, yeah, yeah, but you forgot to mention how deeply flawed your “review” was and how the Government ignored the many concerns raised by the citizens who disputed it from the start. Closure in Leeds will result in a dearth of service down the East of England, in areas where Ethnic minorities are more prevalent. No need to tell you that this is going to result in a growing inequality in neonatal outcomes in the UK. Not that the people from London, including those who came up with this care about what happens beyond Eton, Oxford and Cambridge where they took their political and medical degrees. The S & S team claim that they have engaged these groups is a joke. A 19% response rate from ‘asians’ a 1% response from ‘blacks’ and the rest from caucasians shows how fair and balance their reviewing exercise was. The way they patronise minority groups is astounding! Although they did translate documents into these people’s languages, they did so only a few weeks before the end of the public consultation, and without any apparent understanding of the implications of having only written information. As a nurse from Leicester pointed out to me recently, this decision is going to devastate the service that we have in the UK. There are now 28 paediatric cardiac surgeons remaining in the UK. Two more have left in the last few months, despite the commissioning of their units (one from Liverpool and the other from Southampton). Ironically they were both British, with the exception of 1 surgeon in Bristol, 1 in Leicester and 3 in Birmingham, the rest are foreign (mostly from Italy, but that is by the by!) (The senior surgeon in Leeds is Australian, and he works with an Italian, a Peruvian – until he left last month, and one other foreign doctor) This is a small speciality and this review is destroying it. There is a real lack of insight into the damage that it has done to the profession as a whole, but also the future damage it will do through broadening inequalities in both access to care and probably outcomes.
Please can you supply the evidence that less babies will die? Mr Glyde has been unable to do so, despite repeated requests. ‘Clinicians’ have been unable to do so. The RCN, and Royal Colleges have all failed to supply me, or the other parents who have repeatedly requested this information with any evidence. My conclusion can only be that this is a scare mongering attempt to force a change which has been poorly planned.
This is a great article in parts but I must point out that for once this is not about cuts-its about a national review of Children’s Cardiac Surgery and the focusing of expertise. Sadly however the review has been flawed and its recommendations fail to even meet some of the standards they set themselves. My son has had 2 heart surgeries and numerous other operations at the Gold Standard LGI where all services including maternity are under one roof. Following his 2nd heart surgery he spent 7 months in intensive care and came home on 24hr ventilation. Had the LGI not had a Cardiac Surgery Unit by son would have had to be born in Newcastle and his care would have been split across 3 hospitals in the city. This review means a REDUCTION in the quality of service for patients currently served by the Leeds Unit which is why I am fighting against this decision. For me it is not about convenience, it is about quality Jo_Joseph.
As a grandparent of a 3 year old who has reason to be thankful to the LGI, as the numerous operations (including heart surgery) he has had in his short life have all been under one roof. Imagine the nightmare of travelling to another unit for the heart procedures with the extra stress that would put upon his family. However, I must reiterate that the decision to close some units was not made in order to save NHS money – in fact if the plan proceeds it will be more expensive that keeping all units open. The thinking to concentrate heart surgery in fewer units may be correct but the process which led to Leeds being designated to close was horrendously flawed.
May I suggest climbing down from your high horse and reading the papers setting out the reasoning behind and exploration of these changes. It is about improving quality for all, not just convenience for some, and quality is just as important as quantity.
If the government concentrated their ‘minds’ on recovering the monies wasted on the bankers bonuses and ‘tax-havens’ etc, there would be no need for penalising everybody else.-“All in it together” BS
The ‘reasoning’ behind this review is to create larger fewer centres- however, there is no hard evidence anywhere to suggest this would work! Let me ask shouldn’t population play a key factor in reconfiguration of services…bring the docs to the patients not the other way around. Correct me if I’m wrong, don’t we live in a democracy- 600,000 people in the Yorkshire region and beyond signed a petition opposing the removal of Children’s Heart Surgery in Leeds unit, the very unit that serves the largest population in the country – it has become the largest petition in the country- The reason this campaign has been so successful is down to the logical arguments put forward. Population, all other children’s services under one roof- 18 developed networks where by docs go out to see there patients…Jeremy Hunt has now asked for a review of what has happened, and its most welcome- I believe the courtcase was the last resort… Surgery must not leave Leeds as future generations will pay the price-
Would you mind defining quality? Within this review outcome was deemed not a useful quality measure. I fear that as a parent it would be my MOST useful determinant of how good a service was. I am not alone in those feelings. The Children’s Heart Federation survey concluded that: “Survival and quality of life was the most important priority” Despite that, survival data were not used as quality measurement. Moreover Mr. L. Hamilton (ex paed cardiac surgeon from Newcastle) stated that: “data comparison is not useful…..” Or is it just a case that if data disproves what you are trying to do, just ignore it?????
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