Court ruling hastens decision on Yorkshire children’s heart units

The decision is a blow to the Royal Brompton in Chelsea, west London, which is the largest specialist heart and lung centre in the UK and among the largest centres in Europe.

Hospital chiefs say the current proposals, if they are approved, could put its future in doubt.

The controversial consultation process was launched by the Joint Committee of Primary Care Trusts (JCPCT) of England as part of a national review aimed at streamlining paediatric congenital cardiac surgery services (PCCS).

The Safe and Sustainable review followed the landmark inquiry into children’s heart surgery at Bristol Royal Infirmary between 1990 and 1995, where up to 35 children and babies died as a result of poor care.

In the consultation document the JCPCT expressed the “preferred option” that there should be only two centres for London - one at Evelina Children’s Hospital (at Guy’s and St Thomas’ Hospital) and the other at Great Ormond Street Hospital (GOSH).

Last November the Royal Brompton and Harefield NHS Foundation Trust won a High Court ruling quashing the consultations.

Mr Justice Owen ruled that the JCPCT had failed to assess fairly the quality of the Royal Brompton’s research and innovation and accordingly the consultation exercise was “distorted” and unlawful and had to be quashed.

But today three appeal judges - Lady Justice Arden, Lord Justice Richards and Sir Stephen Sedley - disagreed and overturned the High Court decision.

Allowing the JCPCT’s appeal, they unanimously declared that “the consultation process cannot be said to be unfair”.

But, in a joint ruling, the judges also spoke of the “excellence” of the Royal Brompton and the fact that its work was highly regarded.

They said: “A member of the public might well find it difficult to understand why a centre of the standard of the Royal Brompton should cease to be a centre for paediatric cardiac surgical services under the configuration exercise.”

Sir Roger Boyle, former national director for heart disease and stroke, later made it clear that the option of three surgical centres in London was not ruled out, despite the JCPCT’s two-centre “preferred option”.

Sir Roger said after today’s ruling: “Now that the Safe and Sustainable consultation is no longer quashed, the Joint Committee is able to consider people’s consultation responses and the other evidence received.

“With an open mind the Joint Committee will give further consideration to options for change that include three surgical centres in London and to new proposals that have been submitted during consultation.

“The decision-making committee will carefully consider all the evidence and prepare to make a final decision at a meeting in public on July 4, 2012.”

He described today’s ruling as “an important milestone for children with congenital heart disease as it brings improvements to their services a step closer”.

Later a statement from the Royal Brompton Trust expressed “disappointment” with today’s ruling but said the hospital looked forward to the JCPCT “considering all relevant information” when it comes to decide on the future of children’s heart surgery in England.

The statement said: “In the Court of Appeal we did not challenge the fact that the JCPCT has an open mind; we will now see what they decide.

“The trust took this legal action on behalf of patients and their families. It was action of the last resort and taken with a heavy heart, after a number of attempts to settle the matter at an earlier stage failed.

“But it was taken because we remain convinced that there is a vital role for specialist cardiac and respiratory care for children and older patients to be fully integrated in a specialist trust such as ours, which works with the significant research power of our partner Imperial College.

“We remain convinced that our highly respected services for patients in England and Wales will be harmed if our unit is dismantled as a consequence of the Safe and Sustainable process to date.”

JCPCT chairman Sir Neil McKay also emphasised the three-centre option for London, which could include the Royal Brompton, was still on the table.

He said the appeal court had found the consultation process to be fair, lawful and proper - a judgment that would be welcomed “by specialist heart doctors and nurses, national children’s charities and the families of children with congenital heart disease who have consistently called for an even safer and more sustainable children’s heart service in England”.

Sir Neil added: “It means that we can now take into account the evidence submitted to us by the many thousands of people and organisations in what was the biggest public consultation ever undertaken by the NHS. It is only right all of these voices can be heard.”

In particular, it would now take account “of the respondents who called for us to give further consideration to options with three surgical units in London”.

The JCPCT would also consider a number of new options proposed that included “the surgical centres in Leeds, Leicester and Southampton amongst others”.

Sir Neil said the Royal Brompton’s court action “has delayed an open and honest process of consultation and has been frustrating to many of us, including royal colleges and professional associations, who have said that change to children’s heart services is long overdue.”

He said he welcomed the appeal court’s decision to reject outright “hurtful accusations” made by the Royal Brompton of bias and impropriety against eminent children’s heart doctors sitting on groups that had advised the JCPCT on clinical matters who had connections with Great Ormond Street and the Evelina Children’s Hospital.

The accusations were “personally distressing” to the doctors.