In the last issue of Kirkstall Matters, we reported that an application to take the decision for closure of the Leeds Children’s Heart Surgery Unit to the High Court for a Judicial Review had been submitted. We have been following this story closely, due to the impact it has on Leeds and our local community, but also because Kirkstall Councillor John Illingworth has been instrumental in the bid to obtain correct and tangible information pertaining to the case.

Recently it was reported that the Save Our Surgery has won its challenge to the Joint Committee of Primary Care Trusts (JCPCT) against the Safe & Sustainable consultation over the future of paediatric cardiac care.

The review has revealed some of the fundamental flaws and failiors in the initial evaluation by the Joint Committee of Primary Care Trust (JCPCT). As reported in KM111, the main concerns for all those against the closure are as follows:

– Concerns over the vailidity of the data collection and decision making process.

– Concerns that the comparision criteria and level of scruitiny of the services in each hospital was not fair.

– Concerns that the distance critically ill children would have to travel was not taken into consideration.

None of the councils were represented at the High Court. This is because local authorities across Yorkshire and the Humber have an alternative statutory remedy through their Joint Overview and Scrutiny Committee (JHOSC) and the Independent Reconfiguration Panel (IRP) which is still ongoing. MPs and councilors from the region have been encouraged to submit their arguments to the IRP, but in order to be taken seriously, they need to be able to submit supporting evidence. Kirkstall Councillor, John Illingworth has been gathering this important data.

It would appear however, though every step of the way in their communications with NSCT (The National Specialised Commissioning Team) who are employed to host the information for the review of children’s heart surgery units, that they have been met with opposition and setbacks. It would seem that John has been ignored when requesting essential information that would help them to gain a better understanding of how the decision was made and hopefully answer some of the concerns above. Councillor Illingworth has since had to resort to requesting the information using the Freedom of Information Act, which again has largely been met with opposition and disregard.

The main issues/irregularities arising are:

1. “Word of mouth” recruitment to the assessment and advisory panels, which left Leeds, Leicester & Brompton largely unrepresented on the various decision-making bodies. The “successful” units had a large and unrepresentative caucus in support.
2. Documents removed from some competing bids so that the assessment panel did not see all the papers that the hospitals submitted. Additionally, the self-assessment documents submitted by each hospital were not entirely received or viewed by the panel. This incomplete review of documents has the potential to invalidate the entire Kennedy process and all the subsequent consideration by the JCPCT over the last three years. The JHOSC are trying to find out which of these documents, exactly, were considered by the Kennedy panel, and which of them were not.
3. Apparent bias among some members of the “Kennedy” expert assessment team, for example, Mr James Monro was excluded from the panel because he lent his name to the defeence of the paediatric surgical unit at Southamoton Hospital, however, by the time this came to light the scoring had already taen place and so his scores were still counted!
4. Decisions made on the allocation of Nationally Commissioned Services without the assessors achieving a quorum or visiting all the units that they were supposedly assessing.
5. Unlawful exclusion of the press and public from the meetings of the Joint Committee of Primary Care Trusts (JCPCT). It would appear that the “Safe and Sustainable” JCPCT operated almost entirely in secret, ignoring the provisions of the Public Bodies Admission to Meetings Act 1960. All the other JCPCTs that managed the reorganisation of the London NHS had respected this important legislation and apparently published their agendas and reports before their meetings, welcomed patients and public to their meetings and rapidly published their minutes on the Internet after each meeting had taken place.
6. Whether some of the supposedly “secret” Kennedy sub-scores were in fact known to members of the advisory team.
7. Serious arithmetic errors in the re-allocation of patients to “successful” hospitals which means that Newcastle, Southampton and Bristol are unlikely to achieve “mandatory” national standards. Namely, a table in the Health Impact Assessment purporting to show the numbers of patients transferring between different hospitals under the various options considered by the JCPCT. This table does not add up correctly and in fact contains various arithmetic errors. John states: “We suspect that this reticence may reflect the fact that a corrected version might also show that under the favoured “option B” three centres: Bristol, Newcastle and Southampton would struggle to reach the 400-procedure target that was previously supposed to be inviolable.”
8. That the JCPCT had little idea where the patients lived, and consequently failed to properly evaluate the adverse impact on the health of the most vulnerable patient groups.
9. Selective publication of reports on the Safe & Sustainable website making it difficult for objectors to follow the debate and respond at the most appropriate time. John has requested information time and time again regarding the location of the information he needs. The NSCT have responded by denying access to the information because sourcing it (from their own website) would be too time consuming.

Statements from NSCT / JCPCT have suggested that “children will die” or that patients from Yorkshire and the Humber will receive worse treatment as a result of our “emotional” or “irrational” opposition to their proposed reorganisation. This point was taken up during the Judicial Review, and NSCT / JCPCT were invited to provide evidence in support of their claims. They failed to respond to this explicit challenge.

As this case in ongoing, we will report further on any progress over the coming months.