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Cardiosurgical Facilities, Edinburgh

Volume 12: debated on Wednesday 11 November 1981

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asked the Secretary of State for Scotland what progress has been made by his Department on the provision of adequate cardiosurgical facilities in Edinburgh; and if he will make a statement.

My Department has recently approved a proposal by Lothian health board, which is in accord with the recommendations of the Kay report on cardiac surgery, to build a second cardiac surgery theatre at Edinburgh Royal infirmary. Consultations are well advanced regarding the temporary transfer, for the interim period, of part of the cardiac surgery work load from Edinburgh to Glasgow.

I congratulate my hon. Friend on his first appearance at the Dispatch Box. Is he aware that there is concern in the Lothian region that the health board's proposals will not be adequate to provide for the 800 operations per year that it believes will be necessary? Is he aware that, on the Kay criteria, the number of operations likely to be performed is nearer 600? What does he intend to do about the shortfall?

I am grateful to my hon. Friend for his kind remarks.

The figure of 800 does not appear in the Kay report. We must therefore consider the national picture. The report recommended, and the Government are implementing, a system of three centralised cardiac surgery units in Scotland, each able to carry out at least 600 major heart operations. That meets the estimated needs of the Scottish adult population within the range of 1,600 to 2,000 operations per annum.

I entirely accept my hon. Friend's concern about the difficulties in obtaining information about waiting lists in this respect, a matter on which he has been in correspondence with me. I therefore propose to establish a national cardiac surgery register in consultation with the health board and the clinicians concerned.

Is the Minister aware of the great controversy before he took office about continued centralisation in Glasgow and Edinburgh? If the facilities in Edinburgh have now been outstripped, rather than expanding the facilities there, would it not make more sense to use at least some of the money to expand the services already available in Aberdeen, which everyone believes could be acceptable and would be of great benefit to the population not only of Aberdeen but of the whole of the North and North-East of Scotland?

I am aware of the hon. Gentleman's concern in this matter and have read the Adjournment debate that he initiated in February 1980. The facilities in Edinburgh have not been outstripped. The number of patients in the Grampian area would not justify a unit with a capacity of 600 operations per annum. The Grampian health board acknowledges that it receives a satisfactory service under the present arrangements, but intends to review the matter next spring.

Is the Minister aware that Dundee falls within the Edinburgh area for heart operations, and that, because of the difficulties experienced by the Lothian health board, there is a knock-on problem for Dundee and for Tayside as a whole? Will he consider using the accommodation currently available in the modern hospital at Ninewells in Dundee for cardiac operations to deal with the backlog and to ensure that a decent service is available to seriously sick people in that area?

I entirely accept the hon. Gentleman's point that there is concern about the current delays in the Tayside area because the Edinburgh programme has not yet gone ahead. I must stress, however, that patients who require to be treated urgently are operated on at once. The temporary transfer of some of the work load from Edinburgh to Glasgow, to which I have referred, should help to reduce the waiting times for patients in Tayside.

I welcome my hon. Friend's introduction of a national register for these operations. Will he consider the possibility of establishing a similar register for a small number of other very expensive, high-technology operations, such as hip joint surgery?

I am grateful to my hon. Friend for making that suggestion. I shall certainly look into it.

Considering the choice that might have been made, may I also congratulate the hon. Gentleman on his appointment?