Judge's ruling brings more delays over surgery reorganisation proposed following Bristol Heart Scandal
There could be more delays to the reorganisation of children’s heart surgery after a judge ruled today there were flaws with its process.
The centralisation of paediatric surgery at specialist centres was proposed in response to the Bristol Heart Scandal, where more babies and children than expected died following operations in the city in the 80s and 90s.
Bristol Children’s Hospital - which was purpose-built in response to the recommendations from the independent report into the scandal published in 2001- turned around its surgical results following the scandal and was named as one of the designated centres in July. But campaigners disappointed that their local hospitals were not chosen as specialist cardiac surgery centres launched legal bids to fight the review carried out by the Joint Committee of Primary Care Trusts (JCPCT).
And today Mrs Justice Nicola Davies criticised the way the Safe and Sustainable review of children’s heart surgery was carried out was fundamentally flawed.
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A hearing in the High Court later this month will go into more detail about what the judge’s ruling means for the whole reorganisation and the designation of hospitals, including Bristol, as surgical centres.
The High Court judge accepted the view of solicitors acting for the Leeds General Infirmary’s Save Our Surgery campaign group that the scoring methods used in the decision-making process were fundamentally unfair.
She accepted objectors’ pleas that the decision taken by in July was infected by procedural unfairness and failed to adequately measure the “quality” of various hospitals.
Philip Havers QC, for SOS, argued successfully that it was fundamentally unfair that the JCPCT’s scoring methods when measuring one hospital against another had not been fully disclosed before such a far-reaching decision was reached.
It would have taken only a “minor change” in the scoring to have a “major impact” on the result, potentially taking Leeds above Newcastle in the table, the barrister argued.
Although hospitals were told their final scores when measured against other child heart surgery units, they were denied access to “sub-scores” on which they were based and which could have made a real difference to the outcome.
With just one point standing between Leeds General Infirmary and Newcastle's Freeman Hospital on critical “quality” scores, the judge said basic fairness demanded full transparency of the methods used by the JCPCT.
She said: “I am satisfied that fairness did require disclosure of the sub-scores to enable Leeds to provide a properly focused and meaningful response.”
The judge rejected the JCPCT’s explanation that the sub-scores were no more than “underlying workings”, she said they formed the basis for a consensus score which was ultimately used as a significant tool when assessing the 'quality' of the various centres.
She said they “provided the basis of what ultimately was the difference of one point in the critical 'quality' scoring as between Leeds and Newcastle.”
The next hearing will be at the High Court on March 27 when the judge will decide whether to overturn the JCPCT’s decision, effectively forcing it back to the drawing board.
In response to the ruling chairman of the JCPT Sir Neil McKay, said: “I am very disappointed with the court’s decision. The pressing need to reform children’s heart services is long overdue and experts have cautioned that further delay in achieving the necessary change would be a major set back in improving outcomes for children with heart disease.”
He said the reorganisation would continue and representations would be made to the court that quashing the original decision would be unfair and unnecessary.