The Royal Brompton hospital in London has won permission for a judicial review of what it argues are "fundamentally flawed" NHS plans that threaten to close its children's heart surgery unit. The hospital stands to lose its unit under proposals to reduce the numbers of hospitals carrying out children's heart surgery from eleven to six or seven. Experts agree that children will be safer if heart surgery is concentrated in fewer, larger units where surgeons are more experienced.
However, the proposals put forward by the 'Safe and Sustainable' NHS review, run by a joint committee representing all primary care trusts, have outraged the Royal Brompton, which is one of three hospitals in London undertaking this very specialised surgery and the only one earmarked for closure in the capital. Their services would be merged into those of Great Ormond Street and the Evelina children's hospital.
The Royal Brompton and Harefield NHS Foundation Trust has now been granted permission to proceed to a full judicial review later this year by Mr Justice Burnett at the high court. It argues that the process leading to the public consultation (which has just ended) on a number of different closure options was fundamentally flawed.
"This is extremely good news, first and foremost for patients," said Bob Bell, chief executive of the trust. "We have always supported the principle that all babies and children who undergo heart surgery deserve the best possible care, but decisions about the future of such vital services have to be made on the basis of sound, objective evidence and the decision-making process must, of course, be entirely transparent. These conditions were not met by those responsible for this review."
However, the trust did not succeed in getting the reorganisation stopped in its tracks. Mr Justice Burnett said it "is desirable for the joint committee to continue its work of improving paediatric cardiac surgery for the nation". It was with "some hesitation" that he agreed that the Brompton had an arguable case, he said.
The Brompton claims that the decision to reduce London centres from three to two was not based on any evidence, but was an attempt to ensure London shared "the pain of closure" with other units around the country. The trust also argues that it was not represented on the decision-making body, while the other two London centres were. It says its results are very good and that closure of the heart unit would have a damaging impact on its other services, including adult heart surgery.
Hospital reorganisation plans are invariably hard fought and the Brompton is not the only centre to campaign against the proposed closure of its children's heart surgery unit, but it is the only one to take legal action. Others have sent in mass petitions and MPs from Leeds succeeded in obtaining a debate on the floor of the House of Commons. There have been 70,000 responses to the public consultation exercise, including 20,000 text messages.
Jeremy Glyde, programme director for 'Safe and Sustainable', said: "The rationale for change is supported by medical experts, professional associations and leading national heart charities. Pooling expertise will help the NHS make further improvements to patient outcomes and deliver a truly excellent service." An independent panel would now look into the Brompton's claim that other services would be damaged if the children's heart unit closed, Glyde said.