15 July 2011
Royal Brompton & Harefield NHS Foundation Trust has been granted permission for a judicial review of the ‘Safe and Sustainable’ consultation on the future of children’s heart surgery in England. The Trust believes that the recommended options put to public consultation are fundamentally flawed, such that a consultation based on them is unlawful. Mr Justice Burnett granted permission for a judicial review later in the year, on all grounds advanced by the Trust.
Mr Bob Bell, chief executive of the Trust, said: “This is extremely good news, first and foremost for patients. We have always supported the principle that all babies and children who undergo heart surgery deserve the best possible care, but decisions about the future of such vital services have to be made on the basis of sound, objective evidence, and the decision-making process must, of course, be entirely transparent. These conditions were not met by those responsible for this review, and it is with regret that we find ourselves having to take legal action to ensure that the grave inadequacies of their approach are heard in a court of law. While we are pleased that Mr Justice Burnett has granted permission for a full judicial review to take place, it is a great shame that the Joint Committee of Primary Care Trusts did not listen to our concerns in February. Had they agreed to meet us then to discuss the flaws we had discovered, we would undoubtedly not be in this position today.”
The Trust highlighted a number of areas in the consultation which it identified as flawed. They included:
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The decision to reduce the number of children’s heart surgery centres in London from three to two, which did not stand up to scrutiny and was not transparent. It was based on the perception that London had to ‘share the pain’ of closure in an effort to show willing to other centres around the country, and was not based on any clinical evidence.
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The decision on which two centres were to keep children’s heart surgery was made by a committee that included doctors from each of the two centres which, it was decided, kept their surgery. Both were active in the decision-making process. Royal Brompton was not represented.
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The Safe and Sustainable steering group set criteria, and then ignored them when considering Royal Brompton’s fate. Royal Brompton fulfils the set criteria, with four surgeons undertaking over 400 procedures each year. It is the third largest centre for children’s heart surgery in the country, with very low mortality rates and an international reputation.
The review panel requested information on, and then chose to ignore, the disastrous effects on other NHS services at Royal Brompton if children’s heart surgery were to be withdrawn. Information submitted by the Trust clearly stated: “The removal of paediatric cardiac services would render the PICU completely unworkable, in turn removing an essential underpinning for our paediatric respiratory services for patients with diseases such as cystic fibrosis and DMD[1]. These are widely recognised as one of the leading set of services in the UK, if not Europe: the impact on patients (as well as on the Trust’s long-term financial health and reputation) would be hugely detrimental.” Recognising this error, the Joint Committee of Primary Care Trusts recently announced plans to convene an expert panel to consider the knock-on effects of removing children’s heart surgery from Royal Brompton, but the panel has not yet met despite the public consultation ending on July 1st.
[1] Duchenne Muscular Dystrophy
Read the full press release here
Download the Skeleton Argument for application here
