health

Gordon Henderson Excerpts

Tuesday 18th September 2012 Commons Chamber

[Gordon Henderson (Sittingbourne and Sheppey) (Con)]

One of my constituents, Mrs Collette Pridmore has three children, one of whom—her son, Jacob— suffers from a rare lung disease. Jacob is just eight years old. When Collette got in touch with me, she was extremely worried about her son’s future because she had discovered that the care Jacob receives at the Royal Brompton hospital in London was under threat. Because of the serious nature of his condition, little Jacob needs to spend many weeks each year at the Royal Brompton, where specialist clinical teams have the necessary skills to help him.

Collette suggested I visit Jacob at Royal Brompton and during my visit she arranged for me to meet the doctors and nurses who care for her son. To say that I was impressed would be an understatement. I am sure that many right hon. and hon. Members will know of the good work done by the Royal Brompton, but for those who do not, let me explain something about the services they provide.

The respiratory children’s unit at the Royal Brompton treats some of the most vulnerable children in our country—those with serious lung disease and breathing problems. The Royal Brompton is home to the country’s largest children’s cystic fibrosis unit and the hospital’s experts treat children with muscular dystrophies, severe drug-resistant asthma and a range of other respiratory conditions. These conditions are quite rare, but the concentration of clinical expertise in one place means that knowledge is accumulated and shared, creating the best possible conditions for the care of children such as Jacob. The hospital also carries out research with Imperial college constantly to improve the treatments available.

My visit to the Royal Brompton was inspirational. I saw the very best that the NHS has to offer—the best specialist skills and an incredibly caring environment. These services provided by the Royal Brompton, however, are now at risk. Why? In one word—reorganisation. The threat to close the Royal Brompton’s children’s respiratory services is really not the finest hour for health service reorganisations. This is not an academic exercise; it is about the future welfare of some pretty sick and vulnerable children such as Jacob.

Unfortunately, Jacob’s doctors do not think they will be able to carry on caring for him in the long term, because their intensive care unit is being closed. Without the back-up of intensive care, they will not be able to offer the expert services they do now, because they think it will be unsafe to do so. So why is the intensive care unit being closed? Is it to save money? Is it because it is not a very good unit? Is it because no one needs it? The answer is none of those.

On 4 July this year, a committee of primary care trust chief executives, as part of the reorganisation of children’s heart services in England, made the extraordinary decision to end children’s heart surgery and intensive care at the Royal Brompton. As one of the best-performing and largest centres in England, many Members will have had constituents who have been treated there. The proposed closure will have severe knock-on effects on children’s respiratory medicine.

Although not all Royal Brompton’s young patients need the intensive care unit, many do need it should they deteriorate very quickly. Sadly for Jacob, this has happened to him on several occasions. Jacob’s doctor, Dr Claire Hogg, told me that without an intensive care unit on site, her only option, if Jacob became particularly unwell, would be to try to get him to the specialist intensive care unit at another London hospital which, depending on traffic, could be up to an hour away. To a sick little boy or girl, this could be a lifetime away—quite literally.

A couple of weeks ago Collette Pridmore brought some of the Royal Brompton’s doctors to visit me here. I was shocked by what I learned. Dr Duncan Macrae has discovered that new figures published after the review of children’s heart services took place show that the rate of population increase, particularly the child population, is far greater than previously estimated, most specifically in London where the child population is increasing at almost twice the national average.

This decision, leaving just two centres to offer children’s heart surgery for London and the south-east, was taken using 2006-based national population projections, which have been shown greatly to underestimate the numbers. Equally worrying is the recent data from the UK central cardiac audit database, showing that the number of children having heart operations is increasing year on year. How, then, did the review of children’s heart surgery, using out-of-date statistics on both population growth and the number of children needing surgery, come to the conclusion that London and the south-east can manage with two rather than three children’s heart surgery centres?

The review decided that the Royal Brompton should close its specialist centre and intensive care unit, despite the fact that the hospital is one of the biggest and best centres in the country. Scandalously, the intensive care units and children’s heart units at the other two London centres do not currently have enough beds for Royal Brompton patients, and at least one of them will have to spend large sums of money building new facilities. At a time when the NHS is strapped for cash, that alone is a good reason for reversing the decision to close the Royal Brompton hospital.

The proposed closure is not the result of Government policy. That is not to say, however, that the new Health team, now led by the Secretary of State for Health, my right hon. Friend the Member for South West Surrey (Mr Hunt), cannot intervene. I very much hope that Ministers will agree to meet me and some of the medical staff from the Royal Brompton to discuss our concerns and to see what can be done to reverse this crass decision.

--- Later in debate ---

[Dr Poulter]

I accept that the Secretary of State has always had responsibility for the health service, and that was implicitly made clear in the Health and Social Care Act 2012. It is, however, important that we no longer have a system in this country that micro-manages the delivery of local health care services. We must listen to local doctors and nurses, and put them in charge of the configuration of local services because they are often the best advocates for the needs of local patients. Reconfiguring local services should be led—as per the four tests I outlined previously—on good clinical grounds where there is a clinical case for reconfiguration and where local communities have been consulted. That is something we should listen to and we must move away from the Whitehall micro-management of local health care delivery.

[Gordon Henderson]

Will the Minister give way?

[Dr Poulter]

I will give way one more time, and then I will make some progress.

[Gordon Henderson]

Does the Minister accept that local people wanted Royal Brompton hospital to be kept open, and that the decision to remove the intensive care unit was not taken by local people? The Minister is arguing against himself.

[Dr Poulter]

The initial process for the reconfiguration was started, I believe, by John Reid when he was Secretary of State in 2002, after listening to evidence at the time. We should remind ourselves why we are discussing congenital heart services. All speakers have accepted the principle that there is good clinical evidence—acknowledged by doctors and specialists—that having fewer units actually delivers better care for patients. That was accepted by my hon. Friend the Member for Pudsey. I am not going to go into the rights and wrongs of individual units as that is under judicial review and I will not be drawn further on that point today.