Belfast Telegraph

Wednesday 23 July 2014

Heart surgery for babies must not be taken away

The delivery of children's cardiac services in Northern Ireland cannot be driven solely by statistical analysis, says Sarah Quinlan

Each year in Northern Ireland, more than 250 babies are born with congenital heart disease - the most common birth defect among children born here.

Just under half will require further medical intervention and often surgery. Around 120 paediatric cardiac operations are performed annually at the Royal Victoria Hospital.

Today and tomorrow, an independent panel commissioned by the Northern Ireland Health and Social Care Board, in conjunction with the Public Health Agency, will carry out a review of children's heart services at the Belfast Health and Social Care Trust.

The Children's Heartbeat Trust welcomes any reviews or recommendations that will improve cardiac services here and we want to ensure that the views of parents and families directly affected by these services is a significant force behind any decisions.

Northern Irish families, whose children have heart disease, want to protect the excellent service already provided and to ensure adequate funding is allocated to allow them to continue providing this care.

One possible outcome of this review is that paediatric cardiac surgery may no longer be available in the RVH. If implemented, this could mean that all surgery would be moved to other specialist centres in the UK.

Consequently, all children requiring surgery would need to fly to England, Scotland or Wales.

It is traumatic enough for families to receive a diagnosis that your child has a heart defect.

Giving the additional information that the only effective option involves a plane journey to another UK centre will add a further, horrific burden.

The impact of having a sick child is highly stressful for any family.

It is important that, whenever possible, families here can access all their cardiac care in Belfast and have the emotional and practical support of being close to relatives. The practical and emotional consequences of stopping surgery in Belfast are unimaginable.

Currently, surgery for congenital heart disease is provided by two surgeons employed by the Belfast Trust, with support - where needed - from two surgeons at Our Lady's Hospital in Dublin.

For many years, children with very complex diagnoses are transferred, mainly, to Birmingham Children's Hospital.

We are advised that the review panel will be taking into account the safe and sustainable national quality standards, part of the safe and sustainable review in England.

Two statistical standards highlighted are that there should be 400 operations in each paediatric cardiac centre, with at least four surgeons as part of that team. With a population of more than 50 million, these figures may be achievable in England; however, with a population of 1.6m in Northern Ireland, it's implausible for the region to meet these requirements.

Delivery of complex medical care for young babies should not be driven solely by statistical analysis.

We would support the option that the partnership with Our Lady's Hospital be enhanced and resourced effectively, creating an all-Ireland service working over two sites, with a surgeon based in Belfast working as part of a strong all-Ireland team.

This means that, not only for surgery, but also for standard interventional procedures that require surgical cover on-site, cardiac families from Northern Ireland will not be flown to other centres in the UK.

It is vital that the review takes account of the very real impact their recommendations will have for Northern Irish families who have a child with congenital heart disease.

Recommendations based on demographics in England are not an option in Northern Ireland.

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