Belfast Telegraph

Saturday 30 August 2014

Sick children's lives will be saved by all-island network

Scrapping paediatric cardiac surgery in Belfast would put babies born with congenital heart disease at risk, says Sarah Quinlan

An all-island children's heart surgery network is the only way that the safety of babies born with congenital heart disease in Northern Ireland can be guaranteed.

Every year, a small but significant number of children will require emergency and unplanned interventions and operations. This emergency situation requires immediate lifesaving treatment.

Critical time transfers are essential if these infants, of whom there were five last year, are to survive. That means specialist children's heart doctors, supported by cover from trained children's heart surgeons.

The current consultation being carried out by the health service includes three options which would see the closure of surgery and surgical cover for children's heart interventions at the Royal Belfast Hospital for Sick Children.

The Paediatric Intensive Care Society's professional standard says a "retrieval team should arrive at the referring unit within three hours of the decision to retrieve the child".

Put simply, a child must not be more than three hours from where they can be treated by specialist paediatric cardiologists.

Any plan to close Belfast's paediatric heart surgical services and move children's heart surgery to another centre would be a clear breach of this guideline.

The good news is that, with highly-skilled clinicians from both sides of the border, an all-island network would support and strengthen the provision of specialised paediatric cardiac services here. This working relationship exists already, however, the essential formalisation of this network would see the establishment of a collaborative network between Belfast and Dublin, managing surgery across the island.

This type of networking for the highly-specialised nature of heart surgery for children has already been put into practice.

Two hospitals, in Toronto and Ottawa, nearly 300 miles apart, share surgical expertise managed under one programme. Paediatric cardiac surgeons in San Francisco work closely with colleagues in Sacramento, some 90 miles away.

An all-island network here would have a team of at least four surgeons and in the New Year we will be mapping out how a network could work for Northern Ireland.

Proposals included in the consultation would see surgery and procedures moved to England. The fight to survive among paediatric cardiac surgical units there has led the Secretary of State for Health to ask an independent body to review the recommendations set out for the future of children's heart surgery in England and Wales.

This uncertainty creates a question mark over where Northern Irish children would be accommodated if these proposals were pursued. Our concern is that the children would be shoe-horned into a service in a state of flux.

It is clear that, if surgery were to close in Belfast, it would place the lives of children at unnecessary risk. On a wider issue, it would also have a detrimental impact on other children's health services.

The end of children's heart surgery in Northern Ireland would see a gradual deskilling not only of our paediatric cardiologists, but also of anaesthetists and intensivists working with children with complex heart conditions.

These children would have to travel outside of Northern Ireland for even minor surgery due to the anaesthetic expertise required.

The Royal Belfast Hospital for Sick Children is a specialist children's hospital, not a district hospital. It should stay that way.

The Children's Heartbeat Trust supports the development of safe and pioneering heart surgery as part of an all-island network.

Make your voice heard, respond to the public consultation today.

Write to: Health -amp; Social Care Board, 12-22 Linenhall Street, Belfast BT2 8BS. Or e-mail: PCCSConsultation@hscni.net.

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