Government agencies tasked with undermining viable public services frequently show contempt for the rest of us, by pretending that their proposed cuts will improve service provision. This is exactly what is happening here in Leicester at the moment.
Hence the ongoing debacle surrounding the attempted closure of Leicester’s Glenfield heart unit kicked off (yet again) when Will Huxter, from NHS England, wrote to John Adler, the chief executive of Leicester’s hospitals, to inform him that they plan to close the unit because it will “in the best interests of patients” (June 30).
Incensed by this letter, Mr Adler responded making it clear that his NHS trust “will not sit by while they (NHS England) destroy our fabulous service.” He highlighted, at considerable length all the amazing gains that had been made since NHS England’s “last discredited review.” For instance, one part of his powerful letter to Will Huxter noted:
“We have expanded bed numbers, improved outcomes, invested in staffing, created a new adolescent unit and have briefed architects to create a new single site children’s hospital which will both meet your co-location standard and provide a wonderful new environment for the care of all our younger patients. This progress has all been achieved against a backdrop of many years of uncertainty following the ‘flawed’ decision four years ago to stop Level 1 CHD services in Leicester. It does make me wonder what this service could achieve if NHS England backed these clinicians.”
Richard French, from the charity Heart Link reiterated this point, saying: “For the last two years we have been in regular meetings into expanding services and now the rug has been pulled from under our feet.”
Karen Chouhan, chairman of Healthwatch Leicester City, added her own group’s voice of outrage to the debate:
“We cannot stand by and let this happen. This stated intention from NHS England betrays the evidence of meeting all the standards set by it for the congenital heart centre. Why then has it made this decision three months into a five year plan to establish full compliance with standards.”
Almost immediately every MP in Leicestershire jumped into the fray by publicly giving their support to the campaign to reverse NHS England’s decision, with Leicester City Council quickly passing a motion that backed the local fight-back. Top bosses at the University of Leicester then spoke out in the news media, as have GPs from across the region.
Dr Sanjiv Nichani, a consultant paediatric intensivist, who works at both Glenfield Hospital and Leicester Royal Infirmary, said:
“I am very angry with this decision for the simple reason we are among the highest performing in children’s heart surgery in the country. We were 40 patients short of the magic figure of 375 set by NHS England and on target to expand.”
Speaking bluntly, Dr Nichani explained that the “decision is ill-conceived and shambolic – it is complete folly.” “I am also very concerned that the knock-on effects on other children’s and hospital services has not been fully considered.I believe there is a real risk of children’s lives being lost.”
With regard to the “magic” figure that Leicester’s three surgeons must carry out 375 operations a year, Dr Sally Ruane, chairman of the Leicester Mercury Patients’ Panel and spokesperson for Leicester Campaign Against NHS Privatization, made it clear that Leicester was on track to meet this target anyway. She pointed out how “Currently the surgeons are performing 332 between them and this is well above any evidence based quality threshold.” It turns out that the current evidence based threshold maintains that our three surgeons in Leicester should be carrying out between 150 and 225 operations a year, which of course they are already doing.
Dr Ruane’s statement reinforced the comments made in Mr Adler’s earlier letter to NHS England, within which he noted:
“In 2014/15 we carried out 280 surgical cases. In 2015/16 we increased this to 332 cases. Based on current projections of activity we expect to meet the standard of an average of 375 cases per year, with three surgeons over the next three years.
“To accommodate this additional work this year we expanded our bed-base by 31 per cent (17 beds total) including the provision of an adolescent unit, and a short stay bay at a cost of just under £1million.
“All that aside we would remind you again that the evidence for 125 cases being the ‘magic number’ is selective. As you know, following a worldwide review of literature on behalf of NHS England, the School for Health and Related Research in Sheffield found ‘that, whilst a relationship between volume and outcome exists, this is unlikely to be a simple, independent and directly causal relationship.'”
Building public anger, combined with support of local politicians, has now ensured that the government has been forced to promise that there will be a “full and proper public consultation” on the future of Leicester’s heart unit. This is a great first victory.
Here it should be recognised that the manner in which public opinion is forcing NHS England onto the back foot cannot be overstated, with well-attended public meetings certainly helping to clarify and build local resistance to the proposed closure.
Numerically speaking, the rising tide of public anger is also illustrated by the growing numbers of people signing the two current online petitions with one garnering just short of 21,000 signatures, and a second obtaining 10,732 and counting.
At a public meeting hosted last Thursday by Leicester’s hospital, the head of the children’s heart surgery centre, Dr Aidan Bolger, summed up the determination of the swelling campaign: “We are coming at this with all guns blazing.” While at the same time in the city town hall, the Leicester and District Trades Union Council met and unanimously backed an emergency motion supporting the campaign to save the heart unit. They also agreed to do their best to raise awareness of the forthcoming Leicestershire Against the Cuts public meeting which hopes to help coordinate the growing campaign to oppose the closure of the heart unit (Saturday, July 30 — Secular Hall, Humberstone Gate, 12pm).
The fight must continue and must succeed, because as Aneurin Bevan said when the NHS was founded, it “will last as long as there are folk left with the faith to fight for it”. If you have faith in the NHS then now is the time to get involved in politics to fight for it.