26 September 2011 (updated 3 October 2011)
The judicial review of the ‘Safe and Sustainable’ consultation on the future of children’s heart surgery in England, was heard in the High Court of Justice, London from 27-30 September.
Mr Bob Bell, chief executive of Royal Brompton & Harefield NHS Foundation Trust, said: "We remain firm in our view that the public consultation on plans to end children’s heart surgery at Royal Brompton was unlawful. Our decision to take legal action has been taken with deep regret. But the gravity of the consequences for patients of this deeply flawed consultation process, left us no other option."
The Trust’s case identifies a number of flaws in the consultation. These include:
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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, to show willing to other centres around the country, and was not based on 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 decision to reject Royal Brompton was made on the basis of a supposed weakness in its research, despite the fact that a national assessment showed it to be the premier centre for cardiac research in the country.
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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 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.
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The review panel requested information on, and then ignored the disastrous effects on other NHS services at Royal Brompton if children’s heart surgery were to be withdrawn. Submissions by the Trust clearly stated: “The removal of paediatric cardiac services would render the PICU (paediatric intensive care unit) completely unworkable, in turn removing an essential underpinning for our paediatric respiratory services for patients with diseases such as cystic fibrosis and DMD[1].
On 15 July 2011, Mr Justice Burnett granted permission for a judicial review on all grounds advanced by the Trust.
[1] Duchenne Muscular Dystrophy
