Royal Victoria Hospital: Paediatric Congenital Cardiac Services
Oral Answers to Questions
2:30 pm
Thomas Buchanan (DUP)
3. asked the Minister of Health, Social Services and Public Safety for an update on the future of paediatric congenital cardiac services at the Royal Victoria Hospital. (AQO 2400/11-15)
Cathal Boylan (Sinn Féin)
5. asked the Minister of Health, Social Services and Public Safety to outline his plans for paediatric cardiac care following the recent report by the Health and Social Care Board. (AQO 2402/11-15)
10. asked the Minister of Health, Social Services and Public Safety what guarantees he can give that paediatric congenital cardiac services will be maintained at the Royal Victoria Hospital. (AQO 2407/11-15)
12. asked the Minister of Health, Social Services and Public Safety, in addition to discussions on the retention of paediatric congenital cardiac services at the Royal Victoria Hospital, to outline what discussions he has had with Minister James Reilly about cross-border co-operation in the provision of this service. (AQO 2409/11-15)
Edwin Poots (DUP)
Mr Speaker, with your permission, I propose to take questions 3, 5, 10 and 12 together, as they all relate to the same subject. I also refer Members to my written statement on 1 August, in which I give an assurance that I will not be making any decision on the future of paediatric congenital cardiac services (PCCS) until I am satisfied that there has been a full, open and transparent consultation and that all options for future delivery of PCCS have been robustly considered.
My overriding concern must be, and is, to ensure that the service that we provide is safe and sustainable. The review panel did not find any immediate safety concerns, and that is good news, but it did note that the paediatric congenital cardiac surgery service in Belfast is not sustainable and that potential risks should be addressed within six months.
I have asked the Health and Social Care Board, working with the Public Health Agency (PHA), to develop proposed criteria to provide a clear, objective basis for future decisions on PCCS and related services, and to draw up a commissioning specification for the delivery of the service in Northern Ireland. This work is being taken forward by a working group, which I asked the board and PHA to establish. That group includes patient representatives, parents and clinicians in its membership. There will be a full, open and transparent consultation on the criterion service specification and potential impact on service models. I expect the consultation to begin in October 2012. The consultation responses will help to inform the way forward in identifying the preferred service model for children from Northern Ireland who need specialist cardiac care, and I hope to be in a position to announce my decision early in 2013.
PCCS is a regular item for discussion at North/South Ministerial Council meetings, and, most recently, on 18 July, I met the Minister for Health for the Republic of Ireland, Dr James Reilly, and discussed our mutual wish to fully explore the potential for services on an all-island basis. Officials from both jurisdictions have been engaged in discussions on this matter, and the Republic will have every opportunity to demonstrate potential to deliver this service.
Thomas Buchanan (DUP)
I thank the Minister for his response, but can he assure the House that the parent group representatives will get to play a full role on the working group that he has established and that their voice and concerns will be heard?
Edwin Poots (DUP)
As I indicated, I have asked the Health and Social Care Board, with the Public Health Agency, to do just that and to ensure that parents are represented on that board — and not just represented on the board but have their voices heard. For many people, the quality of care is, of course, the number one priority, but often families have other children. Families must try to work and retain some income during the child's illness, and all of these things can be huge stresses, particularly if they have to go to England to get treatment. So, in all these things, we will give due consideration to these issues and to the concerns that parents raise.
Cathal Boylan (Sinn Féin)
Go raibh maith agat, a Cheann Comhairle. I thank the Minister for his answer. He clearly indicated that he had some discussions with the Minister of Health in Dublin. Will he outline those discussions, and will he agree that we should be developing an all-island approach in this matter?
Edwin Poots (DUP)
There are a number of issues, including capacity. The facility in Dublin is not the best in the world as things currently stand. However, they are committed to building a new hospital, which has been agreed through their Cabinet, by 2016. There are other issues too. For example, although we have no questions about the quality of work, the recording is not up to the standards adopted in the UK. However, we are anticipating receiving records for the past three years in the not-too-distant future.
It is incumbent on me to be very frank with the House. I do not want a second-class service for parents and children in Northern Ireland. I want a local service. These are the conundrums with which we are grappling. I do not have the answers as to whether I can deliver this service without going to the one in England. However, we are going to do our best to ensure that that is the case. We want to work closely with the Republic of Ireland, because that gives us close to the requisite number of children that will require a surgical team to be in place. I think that that is the outcome many parents are looking for.
I thank the Minister for his honesty and frankness on this matter. This is indeed something that hurts, worries, and frightens the people, the families and the parents, involved. It is a very sensitive issue.
I have met, and I ask the Minister to meet, the Heartbeat Trust, which is the parents' organisation. Its deep concern is that when a child is seriously ill and is at death's door, it is very difficult to put that child on a plane and difficult for parents to get organised, particularly women who are just a few hours after coming out of labour. We should see no politics —
I urge the Minister to see no politics or constitutional issues in this matter. It is question of getting a service. I know that he will take that approach. These people are desperate, with children whose lives are threatened, and this is the one circumstance in which co-operation on healthcare across the border could be very useful.
Edwin Poots (DUP)
I fully understand the concerns of the parents, whether it is about travelling to Dublin or to Great Britain, especially if there are other children in the family. At this stage, of the 140 operations that take place, around 90 take place in Belfast and about 50 already take place elsewhere. Many of those cases involve the sickest children, who travel to Birmingham at the moment. The evidence indicates that we are achieving very good outcomes as a consequence.
Clinically, the arguments for going to Birmingham stack up at this stage. However, this is not just a clinical decision, and I want some assurance that we can match the clinical outcomes in Birmingham and ensure that we have the service provided here. It is more likely that the service will be provided in Dublin, but, if possible, I would like to have something in Belfast as well. I do not know whether that is achievable at this point.
Stewart Dickson (Alliance)
Thank you, Minister, for your answers so far. I declare an interest as the great-uncle of a baby who received life-saving surgery in the Royal Victoria Hospital a number of days after his birth. It was impossible for his mother, who had had a Caesarian section, to travel anywhere other than from the Ulster Hospital to the Royal Victoria Hospital. This House, and much more important than that, the parents and the community, demand from you the absolute assurance that you will do your best to ensure that Belfast and Dublin co-operate fully to deliver an appropriate service that is as good as or better than that in Birmingham.
John McCallister (UUP)
Like other colleagues, I have been receiving huge concerns from the community about this issue.
Has the Minister given any consideration to the impact the reorganisation of health services in England will have on the number of people that we send to Birmingham?
Edwin Poots (DUP)
I am confident that, if we decided to take up the Birmingham option, it would be met. That is the clear recommendation from the review team. We cannot easily dismiss the expertise of the review team, and it would be foolish to do so out of hand. At the same time, however, we should explore every opportunity that is available to us to maintain a more localised service without dropping the standards that we would expect, and we expect the best. I know that I would go to the far end of the world if it meant getting the right service for my family, but where we can deliver that quality of service at a local level, we should seek to ensure that we do so.