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As Dr. Aylin said to me, the statistical methods used in the paper are the same ones that exposed the problems at Bristol. It is perhaps not a coincidence that the Healthcare Commission has now started looking at the John Radcliffe. So in addition to the wider issue of the recommendations arising from Bristol, there is the issue of the cluster that was exposed in 1999 at the Royal Brompton and the issue of the John Radcliffe.
There is also a more straightforward issue, if I may call it that, and that is about confidence in cardiac services. When we are dealing with individual constituency cases where we are worrying on behalf of parents who have suffered terribly, it is important not to forget to pay sufficient tribute to what is going on. Tremendous work is going on in hospitals throughout the country. There have been tremendous improvements in recent years. We are only too easily led to forget that doing a heart operation on a seven-week-old baby is an intensely dangerous thing to do. It may be the case that it is slightly less dangerous now than it was in 1983, but to describe any of these operations as routine, as I saw in the press not so long ago, is perhaps to miss the point. None of these is routine. A newborn baby of seven weeks has a heart the size of a walnut, so the work being done is of enormous importance. It is extremely complex and difficult and we should be grateful to the surgeons and pioneers who are doing this work. That makes it all the more important, when they are doing cutting-edge work, that there is a clear record of what has happened in each individual case, because we are probing at the frontiers, so that we can look back in any individual case and see whether what was done was appropriate.
I shall not delay the House much longer, but I want to say two things to the Minister. First, I have a copy of the Bell report for her. In her office yesterday I perhaps naively said to Mr. Chapman of the Brompton hospital that I assumed that he had furnished the Minister with a copy of the report, and it turned out that he had not. I was perhaps rather naive because I thought that the hospital would do everything that it could to help the Minister with relevant documentation, and this is nothing if not relevant, but it does not cast the hospital in a particularly glowing light, so on reflection I perhaps understand why it had not eagerly done that. But it is important to look at it. I hope that the Minister will take it away and study it. I was discussing it with Mr. and Mrs. Lynch this evening. When one reads it again and again, each time new points pop out. It is a detailed report of over 30 pages. I invite the Minister to appoint an official to look at it closely. I know that Mr. and Mrs. Lynch would be grateful for a detailed response to the conclusions of the Bell report. That is the narrow point.
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"a major identifiable professional omission related to audit, the evaluation of outcome from high risk surgical intervention, obligatory when undertaking 'cutting edge' surgery with multiple variables controlling the outcome . . . There is no evidence that when the clinical features of severe neurological damage became obvious, that either surgeon, anaesthetist or cardiologist considered causation and reconsidered any aspect of the process of care for the benefit of future cases.
Once that neurological injury was identified, the clinicians had a direct responsibility to ensure optimal care of the infant which involved referral to the appropriate specialists and a duty to inform the parents of why that was necessary. Care at this stage was characterised therefore by a dereliction of both clinical and professional responsibilities.
The lack of responsiveness, honesty and openness that has characterised the hospital's approach from the initial questions of the family right through to my investigation is out of kilter with public expectation and arguably indicates a broader malaise of ignorance or arrogance or both.
A duty of care extends beyond an examination, investigation, technical procedure or prescribing, and should be founded in an understanding of and sympathy for the plight of the parents with a profoundly ill child, who need to understand the problem, prognosis and plan and need to be able to trust the practitioner and the profession at this very vulnerable time. Empathy and communication do not appear to have featured highly on a list of responsibilities."
I hope that the Minister takes away the Bell report and studies it to consider what further steps may be needed. Will she consider either holding a public inquiry or asking the Healthcare Commission to expand its current review of work at the John Radcliffe hospital into a more wide-ranging review of paediatric cardiac services in the UK? Such a review could also include adult services, because the latest Healthcare Commission review concerns adult cardiac services rather than paediatric cardiac services. That would allow patients to have confidence in cardiac care in this country and, in particular, Mr. and Mrs. Lynch to receive public and open accountability from the Royal Brompton hospital for what happened to their daughter, Sarah.
The Minister of State, Department of Health (Jane Kennedy): I congratulate the hon. Member for South Norfolk (Mr. Bacon) on securing this evening's debate. He should not apologise for securing an Adjournment debate and is not detaining Conservative Members, who are here voluntarily to support him. I am not surprised that the hon. Member for Aylesbury (Mr. Lidington) is here, because I know how assiduous he is in advancing the case of his constituentshe is to be respected when one deals with him across the Dispatch Box, too. Before I get into the serious detail, I wish the hon. Member for South Norfolk well for his wedding later this month.
I acknowledge the hon. Gentleman's interest in the case and know that this particular matter is of great concern to him. If he and the family will forgive me, I will not respond in great detail to his careful exposition of the experiences of the Lynch family, the subsequent
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inquiry and the hospital's response. I want to express my sincere condolences to Sarah's familythe death of a child is always a devastating event, and I can understand Mr. and Mrs. Lynch's need to discover what happened during Sarah's stay at the Royal Brompton hospital. The hon. Gentleman has raised several points about the handling of Sarah's case and the response by the Royal Brompton and Harefield NHS Trust. However, I hope that he agrees that in line with patient confidentiality, it is probably not appropriate for me to respond to some of his detailed points.
People in all sorts of circumstances believe that a public inquiry is the only answer to their problems. The hon. Gentleman may not knowthere is no reason why he shouldthat the Royal Liverpool children's hospital, which is more commonly known as Alder Hey, is in my constituency. It is a much loved and respected local institution, on which families with children across the north-west of England depend. However, the hospital's name was for a time synonymous with the retention of organs from children, many of whom were very sick babies. There was a strong call for an inquiry, which took placeit was a judicial inquiry rather than a full-blown public inquiry. The process resulted in clinicians who were not involved in the incidents that gave rise to the disquiet, and who were seeking to treat, look after and nurture very sick children, losing the confidence of parents at that time. It has taken some years for the trust to recover its position and for clinicians to feel that they have regained the confidence of parents in the region. The hon. Member for Aylesbury will know about public inquiries from our time in Northern Ireland, and we have mixed feelings about them.
I will want to consider the points that the hon. Member for South Norfolk has raised. If he is looking for a detailed response, I will certainly give him that in writing following the debate. I will perhaps give greater thought to the idea of a public inquiry, which I had not considered before this evening, but it is not, instinctively, a solution that I would necessarily encourage.
Mr. Bacon: I understand the Minister's reluctance. She alluded to the Saville inquiry in Northern Ireland, which cost more than £200 million and has apparently never settled anything. In the Bristol case, it was notoriously reported that more than half the money ended up going to the lawyers. There are obviously big problems with public inquiries, but there should be other routes available. Perhaps there could be a Hutton-style inquiry, which could take evidence, before a non-clinician such as a senior judge or a Law Lord, or something via the Healthcare Commission. I hope that the Minister appreciates that there is a widespread nexus of issues and concerns that runs wider than Mr. and Mrs. Lynch.
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