Guy's Hospital: Heart Surgery Unit (Hansard, 25 March 1985)

§ Lord Molloy
My Lords, I beg leave to ask the Question standing in my name on the Order Paper.

§ Lord Glenarthur
My Lords, the continued existence of the cardiothoracic surgery unit at Guy's Hospital has never been in doubt. Lewisham and North Southwark Health Authority had been considering ways of reducing overspending, including the possibility of temporary closure of the unit, before a generous private donation made immediate measures of this kind unnecessary.

§ Lord Molloy
My Lords, is the Minister aware that the men and women and specialists who work in the heart surgery unit are of the ppinion that were it not for the £270,000 donated by this benefactor the unit would have been closed? Is he further aware that there are threats still extant in regard to premature babies with heart trouble requiring heart surgery, and also in regard to dialysis patients?
Can the noble Lord comment on the fact that the heart surgery unit at Guy's is not financed in the same way as other departments? Despite the fact that they do important work, they do not attract money. What is needed is a complete reorganisation at the hospital level, along with other hospitals, so that heart surgery units are treated in exactly the same way and can attract just as much money as other units, and so that this great unit at Guy's Hospital, particularly, may be saved.

§ Lord Glenarthur
My Lords, the fact is that the unit has not been closed, as the noble Lord is aware. Any suggestion that patients might be turned away and die is totally alarmist. So far as funding is concerned, this is primarily a matter for the district and regional health authorities to deal with.

§ Baroness Gardner of Parkes
My Lords, would the Minister confirm that there are many other heart units in London and that the Government recently gave a major grant for the rebuilding of the National Heart and the Brompton Heart and Chest hospitals? Would he also confirm that as between hospitals in London and those throughout the country, there are big differences in the cost of heart operations and the cost-effectiveness of these units?

§ Lord Glenarthur
Yes, my Lords; I am grateful to my noble friend. There are in fact four cardiac surgery units within the South-East Thames region alone. That is a fairly generous provision in comparison with other parts of the country.

§ Lord Kilmarnock
My Lords, can the noble Lord tell the House how long this "temporary" closure would have had to be had this windfall not appeared out of heaven, and is it not the case that some people would have died as a result?

§ Lord Glenarthur
My Lords, I cannot see the point in answering such a hypothetical question.

§ Lord Renton
My Lords, is my noble friend aware that the National Health Service is now costing £17½ billion a year gross, not very much of which comes back in charges on patients and so on, and that that gross sum amounts to about £3,000 a year for every man, woman and child in this country? Is it not therefore a question of deciding how best these very large sums can be spent?

§ Lord Glenarthur
Yes, my Lords; my noble friend puts his finger on a number of important points. The fact is that expenditure on the Health Service has risen considerably. It is absolutely right that decisions on measures of this sort should be taken by the district and regional health authorities concerned.

§ Lord Taylor of Blackburn
My Lords, is the Minister aware that expenditure on defence has risen considerably as well?

§ Lord Hatch of Lusby
My Lords, is the Minister aware that, quite apart from Guy's, many cardiac units in this country are under-employed because of the cuts in the funding of the units? Is he aware that only this month a distinguished heart surgeon in London, outside Guy's, told me that he and his colleagues were under-employed? This is not because of their own wishes, but because the money is simply not available to pay for the care that they wish to accord to potential patients.

§ Lord Glenarthur
My Lords, the problem at Guy's has to some extent arisen because of its success. In fact, it has substantially exceeded its annual quota for cardiac operations. I think the most important thing that we can do in this case is to ensure that the workload and the resources will be matched in future years, and that is what my right honourable friend the Minister of Health is arranging with the health authorities at the moment.

§ Baroness Masham of Ilton
My Lords, may I ask the Minister whether the position at Guy's could not mean that some of the surgeons work so efficiently and quickly that they operate more swiftly and therefore use up their allocation? Could not some of the patients on waiting lists in other districts be sent to that most excellent unit?

§ Lord Glenarthur
My Lords, they already come from other districts to that unit. The fact that this takes place is something which the regional health authority should take account of in conjunction with the capacity of each unit when they set targets and priorities.

§ Lord Ennals
My Lords, will the Minister confirm that, if it had not been for the generous charitable contribution from the United States, there would have been upwards of 150 high-risk patients who were waiting for surgery who would not have had that surgery? Will he also recognise that the Westminster Hospital cardiac unit is now threatened with closure? We therefore have two major cardiac units of absolute 765 excellence in our central London hospitals which are in this situation. Could he not do something to ensure that these valuable services are retained?

§ Lord Glenarthur
My Lords, the fact is that this unit will not be closed. We are grateful for the very generous donation which Mr. John James has made. Other units are matters for their own districts to look into. The most important thing in this case is that, first, it will not be closed, and there is no point in speculating what might have happened if it had had to be closed—I dare say that was one of the options, but there are others as well—and that in future health authorities must match resources with what is to be put forward.

§ Lord Molloy
My Lords, will the Minister not agree that the surgeons at Guy's and their predecessors have done magnificent work in the past, and that their pioneering work is renowned worldwide? Does he not agree that in one of his answers he threatened anyone involved in medicine with some form of punishment if they are successful, and that that must be distressing for all those involved in the National Health Service? Finally, will he comment on whether or not it is true that the health authority concerned with Guy's is also considering, for financial reasons, the elimination of pacemakers?

§ Lord Glenarthur
My Lords, the last part of the noble Lord's supplementary question has nothing whatsoever to do with the Question on the Order Paper. All units concerned with heart work in London are successful. The four cardiac surgery units I referred to in the South-East Thames region are excellent in every respect, and we have every confidence that if there were a problem in one the others could help.

§ Lord Ennals
My Lords, I appreciate the contribution made by Mr. James, but will the Minister accept that it is, after all, only a one-off contribution? Will he leave open the question of the department giving assistance when the time that has been bought by this generous donor has been used up?

§ Lord Glenarthur
My Lords, as I said in answer to an earlier supplementary question, my right honourable friend the Minister of Health is in touch with the regional health authority. It is a matter for them and the district to sort out.

§ The Countess of Mar
My Lords, will the noble Lord allow me to correct the figure given by Lord Renton? It should be £300 per head of the population, and not £3,000 per head.

§ Lord Glenarthur
My Lords, I do not think I should get into a dispute now about mathematics. I am very bad at doing calculations in my head; but I note the remarks of the noble Countess.