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Jane Kennedy: I will come on to those wider concerns in a moment. I am aware that, as the hon. Gentleman described, Sarah's parents have been in contact with the trust over the past 20 years I hope that they can find a resolution to their ongoing concerns. He is absolutely right that it should be possible for that to happen, and in doing so to find a degree of comfort in the process.

Mr. Bacon: I want to say one further thing in relation   to the Minister's comments about patient
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confidentiality. I think that I can speak for the parents when I say that given the events of the past 20 years and the very sad death of Sarah Lynch, I do not think that the parents would have an objection to the Minister speaking about this publicly or writing to them with more details. They would probably prefer it to be on the record. Although I appreciate that the Minister is not in a position to give detailed answers now, I was rather hoping, as I said to her yesterday, that the outcome of this debate would not be that she sits down at 10.30 pm and we have closure, but that she goes away and thinks further about these issues.

Jane Kennedy: I hope that I will be able to give some proper response to the very eloquent case that the hon. Gentleman has made.

No one wants their child to have to go into hospital. Any child having to attend hospital as a patient, for any reason, is a cause for concern for all parents, carers and relatives. As a parent of two sons who are now in their twenties, I know only too well that it is an anxious enough time when things go well. When things go wrong, there can be tragic results, and patients and their families, quite rightly, want answers to their questions and an apology if appropriate. Most often, they tell us that they want reassurances that no one else should have to undergo their experience and that all steps will be taken to avoid a similar incident arising.

There is nothing that we can do to completely take away parents' concerns and anxieties, but there is a lot that we can continue to do to improve the way in which hospitals care for children. Let me, for five minutes or so, describe what we have been doing. I am informed that the cardiac surgery that Sarah received back in 1983 was the most modern of its time. Without that surgery, babies, such as Sarah, born with severe cardiac abnormalities might have died before they were six months of age. Even now, the risks involved with major cardiac surgery on small babies can be high, as the hon. Gentleman said, and parents are sometimes faced with the devastating news that their baby might not survive.

A national review of NHS paediatric and congenital cardiac services was published in December 2003. That found that all units undertaking paediatric cardiac procedures were providing high standards of care for children. We were reassured by the findings of that report. However, neurological damage was, and continues to be, a major and often debilitating complication of congenital heart disease and open-heart surgery, even when the most meticulous steps are taken to avoid it.

I hope that the hon. Gentleman accepts that patient safety is at the heart of our agenda for improving the quality of NHS services. Indeed, I am the first Minister of State to have it as part of her ministerial title. Since 1997, we have been committed to building a better health service for patients everywhere. I am not trying to make a political response by saying that, but seeking to give the Government's position. We have established new, independent standard-setting and inspecting bodies.

Through national service frameworks, national standards are in place for the first time. Locally, trusts now have formal processes in place for systematic
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review and investigation of treatments and outcomes. Those were not previously in place. Indeed, I am informed that the Royal Brompton hospital has for some years had a formal protocol for reporting and investigating neurological injury, so that even the early clinical signs of possible neurological damage are now subject to much fuller investigation.

I am delighted to report today that an audit of significant outcomes for 2004–05 carried out at the Royal Brompton hospital states that no serious adverse events on children were reported. That is out of a total of 391 congenital heart operations, 66 of which were on babies up to one month old.

Mr. Bacon: I did not think for one moment that the Minister was making a political point and I fully accept that improvements have been made over several years and that is to be greatly welcomed. Item 1 of the Bristol inquiry—the Kennedy report—is that the patient should be at the centre of everything we do. I hope that that culture is developing—I stress "developing"—in the health service. However, the patient was certainly not at the centre of everything we do in Mr. and Mrs. Lynch's case. It is encouraging to hear the Minister say that a protocol is now in place to provide for a neurological inquiry in the case of a neurological insult. However, it should be obvious that when there is brain damage, neurologists should be involved. That is common sense and it is extraordinary that such a protocol was not in place in 1983. To this day, the parents have never been able to get an open account and acknowledgement of what was done and not done in the case of their child.

Jane Kennedy: I acknowledge the hon. Gentleman's points, which he makes passionately, and I understand the extra grief that has been caused to the family by what they perceive as the struggle that they have had to get the information. I understand that the expert reports from which he has quoted—not only the Bell report but the others—have not been shared with the trust. If that is the case, would it be possible for them to be shared with the hospital so that it could consider them?

Mr. Bacon: They could be shared with the trust and I would be happy to ensure that they were shared with Minister, too, although an offer was made at one point to make them available to the trust but it was rejected. However, I am sure that, after the debate, it would be interested in examining them and I hope that the Minister will be, too.

Jane Kennedy: I am grateful for that. I am always surprised at how rapidly time runs away with us but I wish to make some important points in response to what has been said.

As the hon. Gentleman said, Sarah's case occurred more than 20 years ago. In the past eight years, the NHS in England has begun to turn itself around. He knows that we have increased investment and even argued vigorously about how that has been done. However, it has enabled the NHS to provide better quality care to patients with safer and more effective treatment, better surroundings and better services. I want briefly to mention one or two of those other factors because not
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only the procedures have been improved. Protocols are now in place partly through learning and understanding from the experiences of families such as the Lynches.

Several well-documented reports in the past few years have commented in depth on poor communication with parents about to the risks associated with cardiac surgery and with parents whose children regrettably suffer brain damage—practice that was prevalent in the 1980s and early 1990s. Perhaps the most significant of those for Mr. and Mrs. Lynch has been the review of Sarah's case, which the hon. Gentleman described, by Dr. Dominic Bell. I have seen a copy of that and although I have not had a chance to read the full report, I have read the summary and the findings.

Following Dr. Bell's report in 2003, the trust acknowledged shortcomings in its communications with the family. It also recognised that there were some failings around the investigation into the power failure that occurred on the evening following Sarah's operation. Paediatric cardiology services have been reviewed extensively by successive inquiries. Much has changed. Significant investments of time, energy and resources have been committed to the paediatric service at the trust—I am not speaking in general terms here; I am referring specifically to the Brompton and Harefield—resulting in double the number of consultant surgeons in post, establishing the cardiac liaison nursing team, enhancing support for patients with neurological injury, and enhancing information and support to patients, parents and carers alike.

As the hon. Gentleman rightly pointed out, Sir Ian Kennedy's report into the events at Bristol provided us with a powerful analysis of the organisation and culture of the NHS in the years up to 1995. Responding to those concerns, we fast-tracked the hospital services module of the children's national service framework, which was launched in April 2003 and emphasised the need to design and deliver care around the needs of children and their families. We have taken on board the points that the hon. Gentleman quite rightly highlighted.

The way in which health professionals present bad or difficult news is an important factor in how it is received, understood and dealt with. That can have a profound influence on the confidence and trust that a family has in the health professionals concerned. The national service framework recommends that staff should have training in the necessary communication skills to enable them to work effectively with children, young people and parents.

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