Legal battle 'could delay changes to children's heart surgery services'
A BRISTOL hospital director says a legal challenge to a national reorganisation of children's heart surgery could delay changes needed to improve the service.
A High Court judge ruled yesterday that there were flaws in the review of paediatric cardiac surgery, which had led to the Leeds General Infirmary's surgical service being earmarked for closure.
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Bristol Children's Hospital
Campaigners fighting the Leeds service's closure launched a legal bid against the Joint Committee of Primary Care Trusts' Safe and Sustainable review because they believed the scoring system used to come to the decision was unfair.
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, when surgery continued despite clinicians raising concerns.
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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 specialist centres in July.
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.
Deborah Lee, the deputy chief executive and director of strategic development at University Hospitals Bristol NHS Foundation Trust , which runs the children's hospital, said: "I feel really disappointed that we are in this place.
"The need to change comes off the back of the learning from Bristol. Anything that means a delay to bringing benefits to children and their families really concerns me."
Ms Lee said she understood the concern of the families who did not want to see their hospital stop providing the service but said the review was "really thorough".
"I feel a sense of disappointment and frustration that we might find ourselves in a period of paralysis and delay," she said.
Work currently being carried out ahead of the transfer was in its planning phase and would not be affected by the judge's decision, said Ms Lee, adding that the trust would forge ahead with its plans.
She said: "Seventy-seven thousand people responded to this consultation and most of them thought this was the right thing to do. The issue with the case is that no-one wanted it to affect their backyard. The case has been won on a very narrow technical point."
The Children's Heart Federation echoed Ms Lee's comments.
In a statement, the charity said: "We are disappointed that this decision will result in further delays to the establishment of the new children's heart care network, adding to the considerable anxiety that some families of children with a heart problem have been living under for many months now. Uncertainty about the final configuration of surgical and cardiology centres is now increasing the variation in quality of services across the network, as it prevents necessary investment and destabilises staff teams – prompting some staff to move out of posts at centres whose future is uncertain.
"Lack of staffing leads to increasing waiting times for vital operations – which is potentially damaging to the frail health of some of the country's most vulnerable children."
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 them to start the process again.
In response to the ruling the 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 setback in improving outcomes for children with heart disease.
"The judgment focuses on a single matter of process, but the case for the reconfiguration of children's heart surgical services remains strong. There is a rare consensus on the need for change right across the board – NHS staff, medical royal colleges, professional associations and national charities all support the case for fewer larger surgical centres, new national quality standards and stronger networks of care.
He said the reorganisation would continue and representations would be made to the court that quashing the original decision would be unfair and unnecessary.
2 Comments
by Peterb11
Saturday, March 09 2013, 12:24AM
“It is really disappointing that people of the seniority of Deborah Lee make these sort of excuses. Bristol is in all the shortlisted options, and whatever happens in Leeds, Leicester or London will not affect them. There has not been investment in adequate care for children in a high dependency area until recently, and now she tries to blame other people for her failings - it really is too much!
She is not telling the truth when she says that most of the 77,000 people who responded to the consultation felt it was right - over 50% strongly opposed the chosen option and only a third supported it. So please get your facts right, Ms Lee.
It is simply not true that there is a consensus of opinion that closing units in Leeds, Leicester and London is right, and the high handed, disingenuous comments of Ms Lee and the Children's Heart foundation only make it worse. Any delay is due to the poor job that the safe and sustainable team did in the first place. At some stage they need to be held accountable for wasting so much time and money, yet still getting this wrong.”
by swwhag
Friday, March 08 2013, 10:45PM
“It is very sad that so many years after the BRI Heart Inquiry, the reconfigurations have still not happened.
However Deborah Lee's comment "Anything that means a delay to bringing benefits to children and their families really concerns me" is interesting. The South West Specialist Commissioning Group reported in June 2009 that a project to scope High Dependency services for children in the South West was approved, subject to funding support from the Strategic Health Authority.
Yet nearly four years later Bristol Children's Hospital still has no High Dependency facilities for children recovering from heart surgery.
Deborah and her colleagues can't blame the Leeds challenge for the South West's failure to invest in the High Dependency services that were discussed in 2009.
The judge in the Leeds case is reported to have said "As the scores (sub-scores of quality) were relevant to the assessment, the breakdown of the scoring should have been disclosed to the centres whether or not the JCPCT proposed to look at it."
"If there is a public law duty to make information available to a consultee disclosure cannot be denied simply because one party does not wish to look at that information."
This further delay in the safe reconfiguration of children's heart surgery is the result of the JCPCT ignoring the law about disclosing information in a consultation. Rather than moaning about it, perhaps it should reflect on why it did not do the job properly and thought it was ok to ignore the law.
The lesson for the NHS (which it never seems to learn), is to be open, transparent and publish data otherwise people will naturally be suspicious and challenge what they perceive as injustice.”