Children's Heart Surgery in Leeds - A Disgraceful Saga
Children's Heart Surgery in Leeds - Fabian speaks out
It is with some difficulty that I contain my anger in order to write objectively about the recent developments surrounding the continuation of children's heart surgery at Leeds General Infirmary. I am, nevertheless, considerably buoyed up by the way that other Leeds MPs, particularly Stuart Andrew (Conservative - Pudsey) and Greg Mulholland (Liberal Democrat - Leeds North West) and I have worked as one, cutting across party differences, to champion local provision for some of the youngest and least fortunate members of our society. Our single concern has been to secure safe local provision of children's heart surgery for the benefit of our Leeds constituents and their families.
Of course we were unanimously delighted by the recent High Court Ruling on the 27th March 2013 which stated that the consultation process regarding the Heart Surgery Union's closure was flawed. The judge, Mrs Justice Nicola Davies, said the decision to close the unit was illegal and 'ill judged'. Not unreasonably we all assumed that the immediate prospect of the unit closing had been averted.
Then, next day, up pops Sir Bruce Keogh, the Medical director of the NHS with a ruling that operations at the Children's Heart Surgery Unit should be suspended as he claimed to have data showing that mortality rates were twice as high compared to other centres. In fact he said there were a 'constellation of reasons' (sic) for suspension citing concerns that staff were not referring complex cases on to other centres with more expertise. Professor Sir Robert Boyle, the Director of the National Institute of Cardiovascular Outcomes Research which oversees the UK mortality data then weighed in with his support saying that the figures were among a number of reasons why work should be suspended at the unit. He recounted that he was advised that two junior surgeons had been left in charge, that wishes from families for their children to be transferred were being ignored and that he had been notified of concerns from distinguished surgeons outside Leeds. Next we learned of the comment from Dr John Gibbs chairman of the steering committee for the Central Cardiology Audit Database that figures used by Sir Bruce Keogh had been 'leaked' and had not undergone the 'usual rigorous checking process' an operation that must always be undertaken before any general conclusions should be drawn from statistical data. It is also reported that up to 150 cases had not been included. To cap it all there is even a gross mismatch in reporting the number of complaints that have been registered. The Leeds Hospital Trust is aware of three. Sir Robert and Sir Bruce have mentioned 12 or 15! Certainly nobody has been to see me with a complaint about the unit. On the contrary, my contact with families has led me to understand just how much the work of surgeons at the unit is trusted and respected.
In the last few days there have been more developments. On Wednesday 11th April 2013, some surgery was allowed to resume at the unit in Leeds, much to everyone's relief - except apparently for Sir Roger Boyle, who questioned the decision and said that he would not be happy to send his own children to the unit. This led to a prompt response from the Health Secretary, Jeremy Hunt MP, who ruled that Sir Roger Boyle would play no further part on the review procedure deciding on the future of the unit. Now, on 16th April 2013 we learn that Sir Roger Boyle has resigned from his post as Director of the National Institute of Cardiovascular Outcomes Research.
On 18th April 2013 we have yet another new twist. NHS England, whose procedures to propose the closure of the Leeds unit were judged 'fundamentally flawed' is to seek leave to appeal against this judgement. This puts yet another time consuming and expensive obstacle in the way of reaching a conclusion to the controversy.
I have some key questions that I demand are answered.
- Why did Professor Sir Roger Boyle release flawed, leaked data on mortality rates to Sir Bruce Keogh?
- Why have Sir Roger Boyle and Sir Bruce Keogh not responded to the statement from Dr John Gibbs that he was 'appalled' at the way the mortality data was used?
- Who are the 'distinguished surgeons' from outside Leeds passing judgement? We need to know if they have any credibility, or knowledge of work in Leeds or an axe to grind in the now seemingly murky world of NHS politics (small 'p').
- Why is there such a discrepancy in reporting the number of complaints about treatment at the unit? Who is telling the truth or are the statistics being manipulated to support prejudiced and self interest points of view?
- If Sir Roger Boyle and Sir Bruce Keogh believed that they had poor statistics for the unit in Leeds, why did they not communicate this as soon as they were in their possession? If they were saving them in order to react to the High Court Judgment were they, in fact, playing politics with young children's lives?
- Was the reaction of Sir Roger Boyle to the decision to recommence some children's heart surgery at LGI motivated solely by pure concern for patients' safety? If there are other issues, what are they?
I want the best possible heart surgery to be available for children in Leeds. I want it to be locally provided if possible. I believe in the work of the Unit at the Leeds General Infirmary. I suspect that professional rivalry is revealing its ugly countenance in the current row. It must stop. Something inside me says clearly that it is taxpayers, through their elected representatives at national and local level who should be deciding what health services they expect and where they should be located.
Annexe (added 22 July 2103)
On the 12th of June 2013, I managed to submit a question to the Health Secretary, Jeremy Hunt MP. This is the Hansard record
Fabian Hamilton (Leeds North East) (Lab): I know that all the families of children affected throughout Yorkshire will welcome today's statement from the Secretary of State. Will he reassure the House that any future review panel, following whatever timetable he decides, will comprise representatives fairly and equally chosen from all the centres that will be affected by any decisions? Secondly, what assurances can he give that rather than the data used in flawed reports, such as the now infamous National Institute for Cardiovascular Outcomes Research 8 April report on mortality data in children's heart surgery units, we will use data that are consistent and reliable?
Mr Hunt: On the hon. Gentleman's second point, we need to be very careful about how we use any mortality data, particularly on specialist services where distortions can be based on just one or two operations. I know that he will agree, however, that we have a responsibility to act if we have genuine concerns. That is what happened and the process over Easter was very difficult. One lesson we have learned in the NHS is that in Bristol it took a very long time-years-before anything was done about the higher mortality rates and we do not want to make that mistake again. I take on board the hon. Gentleman's other point, too.