'Experts' took one hour to damn top hospital

'Experts' took an hour to seal the fate of Britain's top heart hospital

PLANS to close Harefield Hospital were finalised after a review team spent less than an hour looking round the world famous heart transplant centre.

The plan for Harefield, at Hillingdon on the western fringe of London, was finalised last week by Geoffrey Smith, professor of cardiac surgery at Sheffield University, who is leading one of six advisory groups on reorganisation of medical specialties in London appointed by Virginia Bottomley, Secretary of State for Health.

His report on the future of heart surgery in the capital has gone to the newly-formed London Implementation Group, which will eventually reorganise its health services. The advisory teams of doctors were chosen from hospitals outside London so they would be unbiased.

But those in Professor Smith's group devised their plans after a highly pressured visit to London in which they saw 15 hospitals in eight days. Not all of the group visited all the hospitals.

Harefield staff are sceptical of their conclusions because of the hurried visit they made there. The team spent two hours in a committee room at the hospital, most of it taken up in obtaining answers to a questionnaire. The team reluctantly went on a tour of the hospital and spent less than 10 minutes talking to scientists.

Professor Smith said: 'The prize we are all grasping for is to produce cardiac centres in Britain which rank with world famous hospitals such as the Karolinska Institute or the Mayo Clinic. We have the first opportunity in a generation to do this.'

The Karolinska Institute in Stockholm and the Mayo Clinic in Rochester, Minnesota, are multi-specialty hospitals which also have first departments in the other major specialties.

But Harefield staff believe their record is better than any. The Harefield team has performed more heart transplants than any other in the world - 1,334 at the latest count.

Professor Sir Magdi Yacoub, who is going to the Mayo clinic next week as a visiting professor, said: 'We continually exchange ideas with the Karolinska Institute and the Mayo Clinic. Their staff work with us. Our cardiac surgery and our basic science is at least as good as theirs. When it comes to transplantation surgery, transplantation science, and molecular biology, we are way ahead.'

Harefield, a trust hospital, has obtained millions of pounds in appeals which have been used to build two of the most modern intensive care facilities in the country - one for adults and one for children. It has succeeded in working within its budget. It has been suggested that it merge with Northwick Park, in Harrow, also a trust, but which turned in a deficit of pounds 4m last year. No heart surgery has ever been done there.

'It has taken years to build up Harefield and make it a national and international resource. If we are forced to move it will die,' said Professor Yacoub. 'The people will be dissipated and will have to start afresh from a much lower point.'

The reorganisation proposals could yet be stalled by MPs. In order to dissolve a hospital trust Mrs Bottomley must lay a statutory instrument before the House of Commons. If members object, then there will have to be a debate, which the Government, with its narrow majority, might lose.

A further difficulty is the possibility that Harefield could go private - an option which senior staff have considered, but only if all else fails.

John Hunt, chief executive of Harefield, said: 'Most staff here are committed to working in the Health Service. They believe that we should provide people with the best health care possible irrespective of whether they can pay.'

(Photograph omitted)