Socialist Worker

NHS cuts help to wreck trust in staff working to save lives

by Kambiz Boomla
Issue No. 2348

The storm raging over children’s heart surgery at Leeds General Infirmary has become a political row. It has drawn in local MPs, NHS chiefs—and the parents of desperately ill babies.

Surgeons in Leeds were stopped from operating last month after senior clinicians said that death rates there were too high. 

Since then doctors and statisticians have battled over the figures. Surgery at Leeds restarted last week—at least temporarily.

To understand this we need to go back to the tragedy of the Bristol Royal Infirmary in the late 1990s.

The small number of cases in children’s heart surgery means that surgeons have few opportunities to become experts. 

Those at Bristol were not as good as surgeons at other hospitals and more babies died there than elsewhere.

Whistleblower

After a whistleblower at the unit made his concerns public, surgery was stopped and some senior surgeons were struck off.

The NHS then agreed to keep a centralised record of death rates so they could compare outcomes at different hospitals. 

The figures showed a wide variation between units in Britain. They also showed that there are not enough highly skilled surgeons for the number of children’s heart surgery centres.

There is a clear clinical case for shutting children’s heart surgery centres to concentrate the best surgeons in a smaller number of teams to save more children.

This should not be confused with the cuts sweeping the NHS.

It is not the same as closing A&Es. When a local casualty is axed both the journey time to hospital and waiting time goes up. So seriously ill people are put at greater risk and more die unnecessarily.

The time it takes to get to a specialist surgeon is not usually the crucial factor in whether a baby born with a heart defect will survive.

The surgery is often planned in advance and is less time sensitive than A&E admissions. A longer trip to hospital may be inconvenient but can ultimately save lives.

Unfortunately, the clinical case for concentrating this kind of care is lost in the current debate—and it’s easy to see why.

Every time the Tories and NHS bosses want to slash services they tell lies about “best clinical practice”. Some clinicians have even helped them make their case. But most people know that this is a lie and that’s why so many have joined protest marches. 

We don’t know whether the data about children’s heart surgery at Leeds proves that it has a poor record and should be closed. 

But the tragedy of Leeds is already clear as years of cuts have worn down trust—even in those whose only interest is saving more lives.

For this we can thank the Tories, their New Labour predecessors, and all those who gave NHS “rationalisations” the veneer of respectability.

Kambiz Boomla is a GP in east London

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News
Tue 9 Apr 2013, 19:00 BST
Issue No. 2348
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