Hole-in-Heart Operations: Statistics (Hansard, 3 February 1988)

Lord Campbell of Croy
My Lords, I beg leave to ask the Question standing in my name on the Order Paper.

§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Skelmersdale)
My Lords, I regret that information is not available centrally in precisely the form requested. Statistics on the number of open congenital heart operations (which include hole in the heart operations) have been collected for the United Kingdom by the Society of Cardiac Surgeons for the years 1977 to 1985. The total number of open congenital operations was 2,105 in 1977 of which 275 were on babies under one year old. In 1985 the total was 2,044 of which 469 involved patients less than one year old.

Lord Campbell of Croy
My Lords, I thank my noble friend for that reply indicating that only recent records are available. Advances in surgery and technology in such fields (which in this case require specially trained nurses) were not known in the early days of the National Health Service. Should there not be some restructuring of the service other than financial restructuring?

§ Lord Skelmersdale
Yes, my Lords. I agree with my noble friend. So far as concerns the structure of the health service, we now have nine supra-regional centres for cardiac operations which are funded directly by the department. That means that we are able to put money directly where the care is needed.

§ Lord Mellish
My Lords, will the Minister agree that the NHS is a victim of its own success? Should there not indeed be a restructuring of the health service of today, not necessarily in terms of money and manpower but rather in terms of a whole new outlook, particularly with regard to regional authorities?

§ Lord Skelmersdale
My Lords, in my position one can hardly fail to be aware that there is a great deal of discussion going on in this country at the moment as to the future organisation and funding of the NHS. An internal ministerial review is being conducted. Any opinions which your Lordships express will be most gratefully received.

§ Lord Hailsham of Saint Marylebone
My Lords, reverting to the original Answer given by my noble friend, has he any information relating to the success rate in the two age groups to which he referred in terms of survival for more than 12 months?

§ Lord Skelmersdale
My Lords, I regret that I do not have that information. If it is possible to obtain it, I shall write to my noble and learned friend.

§ Lord Molloy
My Lords, will the Minister agree that something must be done speedily to stop the situation where British babies die while they are in the queue waiting for hole in the heart operations? We read in our newspapers about this with a feeling of poignancy and sadness. That would not have occurred many years ago because of the efficiency of the NHS. The subject causes great concern not only to the parents of the children involved but also to many people all over the country. They read that in the country which created the National Health Service, babies are dying for the want of hole in the heart operations. The babies have to wait for such a long time in the queue for hole in the heart operations.

§ Lord Skelmersdale
My Lords, it has already been pointed out to the House this afternoon that we are conducting specialist operations on babies which could not have been conducted at all many years ago. As regards babies who have the operation or who are in the queue, as the noble Lord puts it, we have no evidence that delays are causing deaths.

§ Lord Ennals
My Lords, can the Minister confirm that the breakthrough in that life-saving surgery came in about 1964, and that, if carried out in time, that remarkable operation seems to have a success rate of between 90 and 95 per cent.? Can he also confirm that there is now evidence that resource considerations are causing some delays which are disturbing to those involved in that form of cardiac surgery?

§ Lord Skelmersdale
My Lords, so far as concerns the first part of the noble Lord's supplementary question, I can do no better than to send him a copy of the letter which I shall, if possible, be sending to my noble and learned friend Lord Hailsham. Regarding the second part of his question, I accept—as I have on several occasions in your Lordships' House—that there is a lack of intensive care paediatric nurses in particular. The Government are seeking to deal with that matter in various ways.

§ Lord Molloy
My Lords, is the Minister aware that the answer he gave me earlier will be totally unacceptable to the British Medical Association and to the specialist surgeons who claim that the delays have gravely threatened the lives of children waiting for hole in the heart operations? Is he prepared to accept the views of the British Medical Association and the specialist surgeons? Will he see if the situation can be improved?

§ Lord Skelmersdale
My Lords, of course we all want the situation to be improved; but I do not think that that is the point. To pick an obvious recent example, in the case of David Barber, the coroner said that David died of natural causes and that a lack of nursing staff or the delay in his operation were not factors in his death.

Lord Campbell of Croy
My Lords, with reference to the first supplementary question of the noble Lord, Lord Molloy, perhaps I may ask this question. Does my noble friend agree regarding waiting lists that there were no waiting lists for these operations some years ago because these operations had not been invented? As regards hip operations (which was the subject of Monday's questions) sufferers simply had to go on suffering. We all expect everybody to be able to have such operations under the National Health Service; but that was not the position 30 years ago.

§ Lord Skelmersdale
My Lords, my noble friend is absolutely right and underlines the point that I tried to explain to the House in my first answer to the noble Lord, Lord Molloy.

§ The Countess of Mar
My Lords, may I ask the noble Lord this question? In view of the fact that for some considerable time it has been known that there would be a shortage of paediatric intensive care nurses, did the noble Lord receive early last year any submissions from regional health authorities to increase funding so that nurses could be trained for that purpose?

§ Lord Skelmersdale
My Lords, not to my knowledge; but I am aware that in the West Midlands Regional Health Authority there is a new course for paediatric nurses which is expected to start in the very near future.