Children's cardiac surgery services for Northern Ireland are to be relocated to Dublin within 18 months after Health Minister Jim Wells formally accepted proposals for a single, all-Ireland children's heart surgery centre.
Proposed changes had already been supported by Mr Wells last October after a team of US experts made the recommendations to scrap children's heart surgeries in Belfast's Royal Victoria Hospital. But the final decision, announced yesterday, has sparked a mixed response from both campaigners and politicians.
Surgery stopped last December, with children from Northern Ireland travelling to Dublin and England for the procedures.
The new all-island network is expected to be in place within 15-18 months with the hub for surgery based in Our Lady's Children's Hospital in Crumlin, Dublin. In the interim period, children face further upheaval and have to continue to make the journey to England.
Mr Wells said: "While I fully understand the concerns expressed about the ending of surgery in Belfast, we really had to accept this given the overwhelming clinical evidence that we simply do not have sufficient numbers of patients to meet the very rigorous international standards required for the treatment of this condition."
Following a public consultation on the issue last year, Mr Wells published a cross-border document setting out guidelines for the new all-Ireland service. It set out the framework for the establishment of a single congenital heart disease network across the island of Ireland, as recommended by the International Working Group (IWG) on Congenital Cardiac Services.
The new clinical network will be established from April 1, comprising of a Cross-Jurisdictional Oversight Group and all-island Clinical Network Board, and will be chaired by Dr Leonard O'Hagan, the CEO of the Royal College of Physicians of Ireland.
The review team of US experts - led by Dr John Mayer - concluded there were insufficient patients to sustain a two-centre cardiac surgery and interventional cardiology service in both Dublin and Belfast. The new network would see four surgeons in Dublin each perform around 125 operations a year. But 10 new beds need to be opened in Dublin to cope with the number of patients.
Parents and campaigners who battled for since 2012 to retain specialist services welcomed the new model of care but said the implementation must not be delayed.
Sarah Quinlan, chief executive of Children's Heartbeat Trust, said: "Our overriding priority as we began this campaign was to ensure the treatment provided to children with congenital heart disease was the most appropriate, clinically and in terms of family support. At the start of this process we were promised an improved service, now we need to see this being delivered without delay.
"There is still an interim period of up to 15 months while the new all-island structure is put in place and during that time families still face the upheaval of travelling to England for surgery. Ministers from Belfast and Dublin need to work to reduce that time period as much as possible. We will also be seeking assurances that when emergency surgery is required in Dublin during that interim period it will be available."
UUP's Jo-Anne Dobson MLA said: "The service in Belfast has been cut long before sufficient capacity in Our Lady's Hospital outside Dublin has been created. It is a scandalous situation that for the next 18 months the vast majority of children will have no choice but to continue to travel to England."
In 2012 it emerged that children's heart surgery at the Royal was not sustainable, with operations taking place in either England or Dublin. A review was commissioned by health ministers in Northern Ireland and the Republic of Ireland led by international surgeon Dr John Mayer from Harvard Medical School. He backed an all-island surgery model based in Our Lady's Children's Hospital in south Dublin.