§ Mr. Kenneth Clarke
Following careful consideration of all the issues and the many representations made to us, we have decided to approve the proposals put forward by the North-West Thames regional health authority for changes in the pattern of cardiac surgery services in west central London. These proposals will involve the closure of the small unit at the Westminster hospital and a corresponding increase in open heart sugery at the Brompton hospital. We have taken steps to ensure that there will be no reduction in the level of service in London. There are three main reasons for our decision:
the Westminster unit is too small to be able to continue to provide the sort of high quality service which can be provided at larter units such as the Brompton. It faces difficulties over staff recruitment and recognition of training posts;
the service which at the moment costs £550,000 to provide at the Westminster unit can be reprovided at the Brompton hospital for less than half that sum. The savings will be used by the regional health authority for other priority patient services in the region; and
the proposal is consistent with the longer-term plans of the North-West Thames regional health authority to concentrate cardiac surgery services in three units within the region, including the Brompton. We are quite satisfied that this will enable the regional health authority to provide services at a level sufficient to meet the needs of north-west Thames residents.
These changes therefore will not affect the total amount of open heart surgery available either to London residents or in the country as a whole. Nor do we consider that concern about the effects of the closure of this unit on other services at the Westminster hospital has any real foundation. The Brompton hospital, which is part of the national heart and chest hospitals group, is located less than three miles from the Westminster hospital. It can 469W provide the necessary support for other clinical services there together with all the facilities required for undergraduate and postgraduate medical teaching.
It has been clear for some time that the unit at the Westminster hospital had a doubtful future unless a means could be found to expand its role. Various attempts to find such a wider role have been made in the past 18 months. All have failed. The service has been provided by a locum consultant and the junior medical posts are not recognised for training purposes. It is only sensible to transfer the service to under-used facilities at the Brompton hospital.
Over the next few years we expect there to be a rapid expansion of cardiac services nationally which will largely take place outside London to enable patients to be treated nearer to their own homes. In addition, we have already given the go-ahead to £17 million of capital development at the Brompton site on the Fulham road to support the Brompton in its national and international role.