Mixed reactions over heart surgery move

October 20, 2014

By Christine Keighery

The establishment of an all-Ireland children’s heart surgery centre in Dublin has been met with mixed reactions.

Last week’s announcement from Jim Wells and his counterpart in the Republic, Leo Varadkar, means scheduled paediatric heart surgery in the Royal Victoria Hospital in Belfast will come to an end in favour of a new single all-Ireland surgical unit based in Our Lady’s Children’s Hospital at Crumlin, Dublin.

Mr Wells told MLAs the implementation of a new cross-border model of co-operation  would “deliver safe and effective cardiac care to children in Northern Ireland” and provide significant opportunities for enhancing the support available to families, involving their representatives, as well as clinicians, in governance arrangements and improving communication and the flow of information between clinical teams in Dublin and Belfast.

In 2012 a national report revealed that although services for children in Belfast were safe, the unit at the Royal was not sustainable as such cardiac centres must perform a minimum of 400 children’s surgical procedures in order to maintain expertise and remain cost effective.

About 90 heart surgery operations are carried out each year by the Belfast Health Trust with a further 40 taking place in either England or Dublin.

Hundreds of families have campaigned for heart surgery to be retained in Belfast but many also see the new model as a partnership with Dublin which means that children and their families do not have to travel to England in the long term to undergo life-saving surgeries.

One Newry mum whose 21 month old daughter has undergone a number of heart operations and who will need more heart surgery as she gets older told The Examiner she backed the decision to centralise services in Dublin.

“I feel the Dublin option is much better for families from Northern Ireland as it will mean in the long term they won’t have to travel to England for operations,” explained the mum-of-two.

“When our daughter was just a few months old we had to travel to London for her heart surgery and, although the staff were fantastic, it was very tough on my partner and I.  We were alone without our family support system and we were away from our eldest child the entire time so it was difficult for her too and emotionally draining for us.

“Being able to have her upcoming surgeries performed in Dublin is so much more convenient.  We’ll be just an hour away and with having an older child to think about, it will be much easier with family and friends so close at hand.

“I also feel that, if the new service is a true collaboration between Belfast and Dublin, we’ll be dealing with consultants and doctors who know our daughter and us, and are familiar with her history. That makes such a difference when preparing for such serious surgery.”

The local mum also believes the move will benefit patients on both sides of the border as sufficient numbers of operations will be carried out on patients from all over Ireland to keep surgeons’ skills and experience up-to-date.

Ulster Unionist Councillor David Taylor has however expressed his disappointment at the decision condemning it as “callous” as the immediate impact of the removal of surgery is that more children from Northern Ireland will have to travel to England for elective surgery. This will be the position until appropriate capacity is actually in place in Dublin.

Councillor Taylor said:

“I and many other elected representatives attended public meetings organised locally by the Children’s Heartbeat Trust to discuss concerns surrounding the future of Paediatric Congenital Cardiac Services in Northern Ireland.  It was very clear by the representations elected representatives received and on the basis of the many thousands of people who had signed an online petition calling for the retention of paediatric heart surgery in Belfast that there was widespread public concern about the future of children’s cardiac services in Northern Ireland.

“The Ulster Unionist Party is therefore extremely disappointed at the Health Minister’s decision to cut services in Belfast even though he is well aware that sufficient capacity in Dublin is still at least 18 months away. It’s a reckless decision by him. At the very least he could have renewed the Service Level Agreement (SLA).”

Mr Taylor maintained that parents don’t feel their concerns have been heard and insisted that the new arrangements “will not meet the needs of families.”

“The Health Minister has promised a public consultation lasting 12 weeks, but given that the current arrangement between Belfast and Dublin, the Service Level Agreement (SLA), comes to an end in 10 weeks’ time, it is clear that his mind has already been made up and that this consultation already has a predetermined outcome. At the end of the SLA, more children from Northern Ireland requiring surgery will be transferred to a specialist centre in England.

The UUP Councillor said his party were concerned about the knock-on effect losing children’s heart services from Belfast will have on remaining cardiology skills and associated services.

“The Minister has claimed that the new model will be focused on patient care and safety; it’s essential that this is followed through and that sufficient investment in resources will follow this decision.”