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Child Heart Surgery Reforms Derailed by Court Ruling

Hospital CorridorIn a decision of enormous significance to the NHS, the High Court has ruled that a decision to concentrate child heart surgery services on seven regional centres was fundamentally flawed. The court’s decision puts the whole future of paediatric heart surgery in Britain back up in the air but represents a triumph for campaigners who have fought to keep a specialist team at Leeds General Infirmary.

The court accepted objectors’ pleas that the controversial decision, which was taken by the Joint Committee of Primary Care Trusts (JCPCT) in July 2012, was infected by procedural unfairness in that consultees were kept in the dark about ‘sub-scores’ used to assess the quality of services provided at various hospitals.

The ruling was a blow to hospitals in Bristol, Birmingham, Liverpool, Newcastle, Southampton and two in London which had received the JCPCT’s seal of approval. However, it gives fresh hope to Leeds General Infirmary and other hospitals which were told that their child heart surgery units would have to close.

With just one point standing between Leeds General Infirmary and Newcastle’s Freeman Hospital on quality scores, Mrs Justice Nicola Davies said that fairness demanded full transparency in the decision-making process. The JCPTC’s refusal of a specific request to disclose the sub-scores was ‘ill-judged’.

The JCPCT’s review of paediatric heart surgery across Britain was carried out after criticisms of the existing system were made in the wake of the scandal surrounding infant deaths at Bristol Royal Infirmary. After a public inquiry, Professor Sir Ian Kennedy described children’s healthcare services as ‘fragmented and uncoordinated’ and recommended that surgical expertise be concentrated in fewer, larger, regional centres.

There will be a further hearing at a later date at which the judge will decide whether to overturn the entirety of the JCPCT’s decision, effectively forcing it back to the drawing board.