It has taken a dozen years, involved one of the worst scandals in the NHS’s history and involved five reports. But today, a national plan to concentrate children’s heart surgery in fewer centres for safety reasons was halted and its architects sent back to the drawing board.
Jeremy Hunt, the Health Secretary, announced in the Commons that he was suspending the controversial reform, which would have seen the number of hospitals providing surgery reduced from ten to seven, following the latest of the five reports which said it was based on a “flawed analysis.”
Children’s heart charities reacted angrily saying the “monumental delays” were putting lives at risk.
Anne Keatley-Clarke, Chief Executive of the Children’s Heart Federation said: “For the past 12 years, ever since the Bristol Baby Tragedy, we’ve been campaigning to ensure that another crisis in the care of vulnerable children can never be allowed to happen again. It has been really disappointing to see the implementation of the necessary improvements delayed. We want all heart-children, wherever they live in England to have access to an excellent service.”
Professor Norman Williams, President of the Royal College of Surgeons, said: “We are extremely disappointed that the reform plans aimed at providing the best possible heart surgery for very sick children will be suspended. We understand that there were flaws in the process; however, no process will ever satisfy everyone, and difficult decisions will need to be made by politicians where responsibility ultimately rests.”
The controversial plans to shut three of the ten units were drawn up by the Safe and Sustainable Review, on behalf of NHS commissioners, which began examining children’s heart surgery provision in 2008. That followed the 2001 inquiry by Sir Ian Kennedy into the Bristol children’s heart surgery disaster in which scores of babies died or were maimed by sub-standard treatment, which concluded lives had been sacrificed to maintain the hospital’s status as a specialist heart unit
Two further reviews were conducted following the Kennedy inquiry and a follow up report by him, published in 2011, ranked the units according to the quality and safety of the service they provided.
The Safe and Sustainable Review proposed the closure of three units – at the Royal Brompton hospital, London, Glenfield hospital, Leicester and Leeds General Infirmary – but its plan provoked fury among doctors and patients in the units affected and led to the first legal clashes between NHS bodies.
Last month a High Court Judge quashed the decision to stop surgery in Leeds saying the consultation was “flawed and ill judged.”
Mr Hunt had earlier ordered an independent review of the closure decisions – the fifth examination of the issue – in response to protests from MPs in the affected areas. The report by the Independent Reconfiguration Panel, published on Wednesday, backed the need for change saying heart surgery should “only be provided by specialist teams large enough to sustain a comprehensive range of interventions, round the clock”.
But it said the plans were “incomplete” and left “too many questions” because they failed to take account of adult cardiac surgery and the need to consider the “whole pathway” of patient care.
Mr Hunt said: "This is clearly a serious criticism of the Safe & Sustainable process. I therefore accept their recommendation that the proposals cannot go ahead in their current form and am suspending the review today."
But he added that it was “not a mandate for the status quo or for going back over all the ground already covered over the last five years” because the original argument for improving care was unchanged.
It has been recognised for years that hospitals must maintain a minimum patient throughput to ensure doctors and surgeons maintain their skills, currently put at around 500 operations a year for children's heart surgery. With 3,600 operations annually in the UK, the arithmetic dictates a maximum of seven children's cardiac surgery units.
Mr Hunt set a deadline of the end of July for NHS England, which took over responsibility for the Safe and Sustainable Review in April, to come up with next steps in the process.