Hospitals to close heart units after years of delays that 'cost children's lives' The Royal Brompton hospital in London, one of three losing their children's heart surgery units. The Royal Brompton in London and hospitals in Leicester and Leeds are to lose their children's heart surgery units in an NHS reorganisation effort that has taken more than a decade and cost, it is alleged, children's lives because of the long delay. The final decision was taken on Wednesday evening at a lengthy meeting of the NHS joint committee of primary care trusts. It brings the number of hospitals performing complex operations on small children's hearts from 11 to seven - the John Radcliffe in Oxford has already stopped following a spate of deaths in 2010. The Royal Brompton had fought hard to avoid closure of its unit, taking its case to judicial review in the high court, which it lost. "It is very difficult to know what to say at times like these but it is even more difficult to try to understand how this committee could have come to such a decision," said its chief executive, Bob Bell. Closing the surgical unit would mean the loss of paediatric intensive care, which would lead to the destruction of a world-class paediatric respiratory service treating children with cystic fibrosis, chronic asthmas and other conditions, he said. But the committee ruled that only two of the three London children's heart surgery units should remain and chose to keep those at Great Ormond Street and the Evelina children's hospital. Leeds General Infirmary and the Glenfield hospital in Leicester also lose their children's heart surgery units. The hospitals, however, are intended to remain as networks for cardiology services, where children will be seen and assessed for operations. The changes are in the interests of children, said the committee. "This is a landmark decision that clinicians and patients have long called for which will enable the NHS to improve care for children with congenital heart disease," said Sir Neil McKay, its chairman. The needs of children, not the vested interests of hospitals, have been at the heart of this review. We only took the decision today after undergoing a robust, fair and transparent process which has already withstood the scrutiny of the highest courts in the land. Before making our decision, we carefully considered the responses to public consultation and all the available evidence and advice. Leslie Hamilton, a leading heart surgeon and former president of the Society for Cardiothoracic Surgery said the decision had to be taken. Operating on children's hearts is truly demanding and has become more complex over time. Such complex surgery is best delivered by large surgical teams who can guarantee care at all times of the day or night. By concentrating surgery into seven centres we can continue to improve outcomes and reduce the side effects of surgery. Larger teams of surgeons will result in fewer cancelled operations, reduce the strain on individual surgeons and ensure the service is sustainable for the long term," he said. The closure of children's surgery units in some hospitals, in order to concentrate services in fewer, more expert centres, was recommended over a decade ago - precipitated by the Bristol babies scandal. In the late 1980s and early 1990s, the Bristol Royal Infirmary (BRI) had high death rates during and after complex operations on the tiny hearts of children who were born with congenital defects. This was highly specialised work and the cases were relatively few. The consultant anaesthetist Stephen Bolsin, who had collected data on the outcomes at the BRI where he worked, blew the whistle - warning the NHS that death rates were higher than at other hospitals. A major inquiry eventually found that babies had unnecessarily died - their lives could have been saved if they had undergone their operations elsewhere. Two doctors - the senior children's heart surgeon and the hospital's medical director - were struck off the register by the General Medical Council and a second surgeon was suspended. An attempt by the Monro review in 2003 to decide which surgical units should go failed to get the backing of politicians - all hospital closures are politically sensitive. The leading heart surgeon Sir Bruce Keogh, who became NHS medical director, pushed the process on and the present committee, made up of primary care trusts, came into existence. But while the process has been slowly moving ahead, serious concerns have come to light at two other hospitals. Four deaths at the John Radcliffe hospital in Oxford led to an inquiry and the suspension of children's heart surgery there. Leeds also had an inquiry following allegations that children were suffering damage during operations. In an interview with the Guardian, Bolsin said the delays in closing centres and concentrating expertise had cost children's lives. Guidelines were set out by the royal colleges as early as 1980, before the Bristol scandal broke. "There have undoubtedly been more deaths in more centres such as Oxford and Leeds because the profession or the Department of Health did not follow these guidelines," he said.