Concern as children’s heart ops move to Dublin

April 29, 2013

By Christine Keighery

Parents and relatives across Northern Ireland have been expressing their outrage after health authorities recommended children’s congenital heart surgery should move from Belfast to Dublin.  The change is intended to ensure that doctors get the opportunity to perform enough procedures to maintain their skills, but parents have warned that children’s lives will be put at risk if such a move goes ahead.

The board announced last Thursday that children who required planned surgery should travel to Our Lady’s Children’s hospital in Crumlin, South Dublin, with an improved transport network from Northern Ireland to help meet the three-hour timeframe for emergency surgery. Support cardiology services in Northern Ireland will also be enhanced.

The recommendation for an all-island service awaits approval from Stormont Health Minister Edwin Poots, who said he intends to hold further discussions with republic counterparts and explore the scope for flexibility in the location for the future delivery of the service without compromising patient safety.

According to Children’s Heartbeat Trust charity, around 250 babies are born in Northern Ireland each year with congenital heart disease. Last year a national report advised that centres across the United Kingdom must perform a minimum of 400 children’s surgical procedures each year to keep skills updated but The Royal Belfast Hospital for Sick Children falls short of this number, with a volume that is decreasing.  The Health board’s review found therefore that undertaking heart surgery in Belfast was no longer sustainable due to the small population being served which means lower than the recommended number of surgical procedures are carried out for medics to maintain skills.

One Newry mother, whose daughter was born with a congenital heart defect, spoke to The Examiner about the changes to the heart service and what it means for her family.  Her four month old baby daughter was born with a complete atrial ventrical septum defect and needs a life-saving operation.  She has been cared for since birth by staff in Daisy Hill and the Royal Children’s Hospital as doctors and nurses battle to get her strong enough to undergo vital surgery.

The mum of two has already been advised that her daughter will have the surgery in Birmingham or London, due to the changes in the service in Belfast, and says she is concerned about the distance from her family and her other two year old daughter.

While she is confident that the surgeons in England have the necessary skills to perform the operation, she admits the distance from the moral support of her family and the separation from her other two year old daughter will be difficult for her.

“I think the distance is going to make things more difficult for us so I can see how parents from Newry and further away are concerned about operations being done in Dublin. It’s a longer journey in an already stressful situation which keeps you separated from the rest of your family for hours and days,” she said.

The local mum says many parents are also worried about the lack of rapport Dublin Doctors will have with patients from Belfast.

“We’ve been told that pre-care and post-care will always be in the Royal, which is great as staff have built up a relationship with a child who has been hospitalised for a long time.  Doctors in Dublin will simply be reading about our children from notes they’ve been sent, and that’s a concern for many people.”

The cost of travelling and accommodation in Dublin will also impact on a lot of parents, according to the young mum, and, with reports that minor heart operations will also be carried out in Dublin, this will cause further inconvenience and worry for many.

The local woman’s sentiments have been echoed throughout the province with parents and campaigners asking board members who will be responsible when a child dies?

Executive officer of the Heartbeat Trust, Sarah Quinlan said,

“Shifting surgery to Dublin requires 24 hours, seven days a week specialist transport services which are not currently in place, have not been tested and are vulnerable.”

Dr Paul Oslizlok, a paediatric cardiologist at Our Lady’s Children’s Hospital, Crumlin, said he understood some parents in Northern Ireland might be concerned if a situation developed late at night that required them to travel to Dublin for surgery at short notice.

However, he said he believed the facilities and the transport mechanisms were in place to deal with such a scenario and cited a recent example where a critically ill baby in Belfast was being operated on in Crumlin less than two hours after they had been alerted to his condition.

Meanwhile Health Minister, Edwin Poots admitted he had “issues and concerns” about the recommendations made by the working group and said there was a “weakness” in the proposals in respect of newborn babies who required heart surgery.

The Stormont MLA said he was due to meet the Irish health minister about the surgery changes and would attempt to make special arrangements for newborns.

Mr Poots added that it was “impossible” to retain full children’s heart surgery in Northern Ireland because the number of procedures carried out annually was hundreds short of what is required for a sustainable service.

Irish Health Minister, James Reilly said he was happy that Dublin will have the capacity to look after children from Northern Ireland and that it was important to himself and the Northern Ireland Health Minister that they “improve the outcomes of patients”.

“When it comes to national health issues I think we tend to put politics aside to get a better outcome for our patients,” he said.

“We will be looking to facilitate this in every way.”