War of words continues over closure of Leeds child heart unit

Key NHS adviser defends figures behind suspension of surgery and says 'two relatively junior doctors' were left running the ward

Another voice has entered the war of words over the suspension of heart surgery at children's hospital ward in Leeds.

Yesterday the health service's top doctor and a local MP clashed, with Greg Mulholland- Liberal Democrat member for Leeds North West- calling Sir Bruce Keogh's decision to suspend congenital heart surgery at the ward in Leeds General Infirmary (LGI) "an absolute scandal."

Disagreement centred on the validity of figures Sir Bruce, NHS Medical Director, used in the decision.

And this morning Professor Sir Roger Boyle, director of the group overseeing mortality data across the health service, said he advised the suspension, and that the figures were among a number of reasons for doing so.

He told BBC Breakfast that concerns were raised over two "relatively junior surgeons" who had been left in charge of the unit, as well as from families of patients who claimed their requests to be transferred to other units were ignored.

He said: "I was aware last weekend of other concerns being raised about Leeds, concerns raised by distinguished surgeons who don't work in the area.

"Concerns raised by families through the Children's Heart Foundation that they weren't being given the opportunity to be transferred to other units when they'd requested that.

"And I was also aware a senior surgeon was away on holiday, another surgeon was suspended and that left the service being offered to the public by two relatively junior, local surgeons.

"To have two relatively inexperienced people holding fort, without the ability for any senior advice, is a precarious situation in my view.

Doubts were cast over the early draft of mortality figures as sources at Leeds Teaching Hospitals Trust claimed as many as 150 cases may be missing from the Leeds data and, if they were included, the mortality rate would fall within the normal range.

But Sir Roger, director of the National Institute of Clinical Outcomes Research, and the Government's former national director of heart disease, said further analysis which included those cases still showed a "gap" in mortality rates at the hospital.

"In fact, the data has been re-analysed with these extra cases and we still see this gap in mortality rate," he said.

"I would not have been able to sleep this weekend knowing that there were people who might have been operated on in a potentially unsafe environment."

It was 8am on Thursday morning when Sir Bruce and two colleagues marched into the office of Maggie Boyle, chief executive of Leeds Teaching Hospitals Trust, and ordered her to suspend heart surgery on children.

He had been shown preliminary data on Wednesday by Sir Roger, indicating that the children’s heart surgery unit at LGI had a mortality rate for 2010-12 that was at least twice the average.

Coincidentally Sir Bruce had received calls from senior doctors in other units, including Bill Brawn, a recently retired cardiologist in Birmingham, expressing concerns about staffing at the Leeds unit and the referrals process it operated.

Hours later, Ms Boyle announced the temporary suspension to allow an internal review to take place, as instructed, as if it were the Trust’s own decision.

The timing was embarrassing, coming the day after the High Court quashed a plan to close the unit – part of a national reorganisation of children’s heart surgery –  saying it was “legally flawed.”

The decision triggered a war of words between senior doctors and campaigners yesterday over the real reason behind  the suspension, the credibility of the mortality statistics, and the motivation of the whistle-blowers.

Dr John Gibbs, chair of the paediatric cardiac clinical audit which supplied the mortality data and who is recently retired from LGI, said he was “furious” the data had been used because it was “not fit to be looked at by anyone outside the committee”.

And Mr Mulholland said he was “stunned and appalled” by Sir Bruce’s action and called on him to resign. “To have arrived in Leeds and done this, without warning, just one day after the decision to close the Leeds unit was proved in a court of law to have been unlawful, beggars belief. I am absolutely confident not only that his action was unjustifiable but that it was based on incorrect factual information and biased cardiologists at rival units.”

Sir Bruce, a former heart surgeon who pioneered the publication of comparative death rates for adult cardiac surgery a decade ago, said there had been “rumblings” in the cardiac surgical community for some time that “all was not well with Leeds”. Speaking on Radio 4, he said he had made the decision to intervene at Leeds after receiving two phone calls on Tuesday from “highly respected surgeons” who had told him they “had to speak out”.

He added: “I was really disturbed about the timing of this. I couldn’t sit back just because the timing was inconvenient, awkward or would look suspicious, as it does.”

His decision was backed yesterday by Sir Roger and an adviser to the Safe and Sustainable Review, who alerted Sir Bruce to the latest mortality statistics  on Wednesday.

Speaking to The Independent, Sir Roger said: “This data that has caused all the uproar arrived on Wednesday morning at a time when the service in Leeds was running on two junior locum heart surgeons. Social media had carried reports of a spate of deaths [at Leeds] and 15 families had complained to the Children’s Heart Federation that they had not been given the opportunity to be treated elsewhere.

“The data is preliminary, and it has not been validated, and I told Bruce that was the case. But when you put it together with all the other concerns, there was no alternative but temporarily to suspend operating. The fact that it happened on the day the judge told us our consultation process was illegal was chance.”

Dr Gibbs said in an email to The Independent: “This data was in its very early stages and was nowhere near robust enough to be released to anyone.

“The steering committee has only had one working day to look at it and has already found a systematic error which excluded some cases, with a substantial resulting change in Leeds’ standardised mortality ratio.

“I sense a conflict of interest here. It rings of politics rather than proper process.”

News
people
Sport
FootballGerman sparks three goals in four minutes at favourite No 10 role
News
Rumer was diagnosed with bipolarity, attention deficit hyperactivity disorder and post-traumatic stress disorder: 'I was convinced it was a misdiagnosis'
peopleHer debut album caused her post-traumatic stress - how will she cope as she releases her third record?
Sport
A long jumper competes in the 80-to-84-year-old age division at the 2007 World Masters Championships
athletics
PROMOTED VIDEO
Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
Life and Style
ebooksFrom the lifespan of a slug to the distance to the Sun: answers to 500 questions from readers
Sport
Radamel Falcao was forced to withdraw from the World Cup after undergoing surgery
premier leagueExclusive: Reds have agreement with Monaco
Arts and Entertainment
'New Tricks' star Dennis Waterman is departing from the show after he completes filming on two more episodes
tvHe is only remaining member of original cast
Life and Style
Walking tall: unlike some, Donatella Versace showed a strong and vibrant collection
fashionAlexander Fury on the staid Italian clothing industry
Arts and Entertainment
Gregory Porter learnt about his father’s voice at his funeral
music
Arts and Entertainment
tvHighs and lows of the cast's careers since 2004
Life and Style
Children at the Leytonstone branch of the Homeless Children's Aid and Adoption Society tuck into their harvest festival gifts, in October 1936
food + drinkThe harvest festival is back, but forget cans of tuna and packets of instant mash
Sport
Lewis Hamilton will start the Singapore Grand Prix from pole, with Nico Rosberg second and Daniel Ricciardo third
F1... for floodlit Singapore Grand Prix
New Articles
i100
Life and Style
Couples have been having sex less in 2014, according to a new survey
life
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Volunteer Trustee opportunities now available at The Society for Experimental Biology

    Unpaid Voluntary Position : Reach Volunteering: Volunteer your expertise as Tr...

    Early Years Educator

    £68 - £73 per day + Competitive rates of pay based on experience: Randstad Edu...

    Nursery Nurse

    £69 - £73 per day + Competitive London rates of pay: Randstad Education Group:...

    Primary KS1 NQTs required in Lambeth

    £117 - £157 per day + Competitive London rates: Randstad Education Group: * Pr...

    Day In a Page

    Scottish referendum: The Yes vote was the love that dared speak its name, but it was not to be

    Despite the result, this is the end of the status quo

    Boyd Tonkin on the fall-out from the Scottish referendum
    Manolo Blahnik: The high priest of heels talks flats, Englishness, and why he loves Mary Beard

    Manolo Blahnik: Flats, Englishness, and Mary Beard

    The shoe designer who has been dubbed 'the patron saint of the stiletto'
    The Beatles biographer reveals exclusive original manuscripts of some of the best pop songs ever written

    Scrambled eggs and LSD

    Behind The Beatles' lyrics - thanks to Hunter Davis's original manuscript copies
    'Normcore' fashion: Blending in is the new standing out in latest catwalk non-trend

    'Normcore': Blending in is the new standing out

    Just when fashion was in grave danger of running out of trends, it only went and invented the non-trend. Rebecca Gonsalves investigates
    Dance’s new leading ladies fight back: How female vocalists are now writing their own hits

    New leading ladies of dance fight back

    How female vocalists are now writing their own hits
    Mystery of the Ground Zero wedding photo

    A shot in the dark

    Mystery of the wedding photo from Ground Zero
    His life, the universe and everything

    His life, the universe and everything

    New biography sheds light on comic genius of Douglas Adams
    Save us from small screen superheroes

    Save us from small screen superheroes

    Shows like Agents of S.H.I.E.L.D are little more than marketing tools
    Reach for the skies

    Reach for the skies

    From pools to football pitches, rooftop living is looking up
    These are the 12 best hotel spas in the UK

    12 best hotel spas in the UK

    Some hotels go all out on facilities; others stand out for the sheer quality of treatments
    These Iranian-controlled Shia militias used to specialise in killing American soldiers. Now they are fighting Isis, backed up by US airstrikes

    Widespread fear of Isis is producing strange bedfellows

    Iranian-controlled Shia militias that used to kill American soldiers are now fighting Isis, helped by US airstrikes
    Topshop goes part Athena poster, part last spring Prada

    Topshop goes part Athena poster, part last spring Prada

    Shoppers don't come to Topshop for the unique
    How to make a Lego masterpiece

    How to make a Lego masterpiece

    Toy breaks out of the nursery and heads for the gallery
    Meet the ‘Endies’ – city dwellers who are too poor to have fun

    Meet the ‘Endies’ – city dwellers who are too poor to have fun

    Urbanites are cursed with an acronym pointing to Employed but No Disposable Income or Savings
    Paisley’s decision to make peace with IRA enemies might remind the Arabs of Sadat

    Ian Paisley’s decision to make peace with his IRA enemies

    His Save Ulster from Sodomy campaign would surely have been supported by many a Sunni imam