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Heart Surgery (Leeds)

Volume 561: debated on Monday 15 April 2013

(Urgent Question): To ask my right hon. Friend the Secretary of State for Health if he will make a statement on Leeds children’s heart surgery unit.

Following the deaths of 30 to 35 children at the Bristol royal infirmary between 1991 and 1995 and the subsequent inquiry, children’s heart surgery is rightly the subject of great public concern.

With respect to Leeds general infirmary, there are three issues that the House will want to be updated on: was it right to suspend children’s heart services at Leeds on 28 March; was the decision handled in the best way possible; and, given his public comments, is it appropriate for Professor Sir Roger Boyle to have a continuing role in the Safe and Sustainable review of children’s heart surgery?

First, was the right decision made? The answer is categorically yes. The principle of “first do no harm” must run through the very heart of the NHS. If there is evidence that patient safety is at risk, it is absolutely right that the NHS acts quickly and decisively to prevent harm to patients. However difficult or controversial, we must never repeat the mistakes made at both Mid Staffs and Bristol, where arguments over the quality of data prevented action that could have saved patients’ lives.

Secondly, was the decision handled properly? On 26 and 27 March, Sir Bruce Keogh, NHS England’s medical director, was given a range of critical information about the quality of care at Leeds: statistical data that indicated higher than expected mortality rates; concerns about staffing rotas; and further concerns from parents and a national charity about the way the most complex cases were referred. With the agreement of the LGI, Sir Bruce took the entirely appropriate decision to suspend children’s heart surgery while further investigations were made. The families were informed on the day the decision was taken to suspend services, 28 March.

On 29 March—Good Friday—the day that decision became public, I spoke with the right hon. Member for Leeds Central (Hilary Benn) and my hon. Friends the Members for Pudsey (Stuart Andrew) and for Leeds North West (Greg Mulholland) to inform them of the situation. My conclusion is that, on the basis of the information available to him, Sir Bruce behaved entirely properly. He was also right to authorise the restarting of surgery from 10 April for low-risk patients on the basis of more complete data and assurances from the trust.

The third question is whether, in the light of his recent comments, Professor Sir Roger Boyle can have a continuing role in the Safe and Sustainable process. Sir Roger is one of our leading heart surgeons. He did the right thing in informing Sir Bruce of his concerns over Leeds’ mortality data. He has also played an important role as an adviser to the Safe and Sustainable review of children’s heart services. However, it is the view of Sir Bruce Keogh, with which I concur fully, that Sir Roger’s comments to the media on 11 April could be seen as prejudging any future conclusions of that review. It is therefore right that Sir Roger plays no further role in its deliberations.

I am grateful to my right hon. Friend for his answers. No one would disagree with the point that information that is provided about the safety of a unit should be investigated. However, the quality of the information and the source of the complaints raise serious questions about the proportionality of the action that was taken and, more importantly, about the motives of the complainants. Sir Roger Boyle was a key adviser to the Safe and Sustainable review, which proposed an illogical outcome for northern England. His recent actions and comments surely prove that the decision to close the Leeds unit was predetermined.

Sir Roger leaked data that were unverified to argue for the suspension of surgery—an action that was described as “appalling” by their author. The information was inaccurate and, when corrected, demonstrated that the Leeds unit was safe. In fact, it showed that it is in a similar position to the units at Guy’s and Alder Hey. Why did Sir Roger not recommend the suspension of surgery at those units? Is it because those are the ones that he and the Safe and Sustainable review recommended as designated centres?

Furthermore, on Friday, despite detailed scrutiny that proved that Leeds was safe, Sir Roger claimed that it was on the edge of acceptability and that he would not send his daughter there. Those comments demonstrated a clear bias against Leeds and were irresponsible in respect of parents whose children are facing surgery. In addition, one of the whistleblowers has been identified as a surgeon from the Newcastle unit, which is another example of vested interests.

The suspension of surgery and Sir Roger’s comments have caused huge anxiety and concern among patients and staff, and have hurt the reputation of the hospital, which it has taken years to build. I therefore ask the following questions of my right hon. Friend.

How can we have faith in the Safe and Sustainable review, given that its key adviser has behaved in such an appalling and biased manner? Despite the fact that he will no longer take any part in the review, the decisions remain. Does this matter not prove that Sir Roger acted in a predetermined manner? Is it not vital to put the patient’s interests first, rather than NHS politics? Does my right hon. Friend agree that Leeds has been treated disproportionately when compared with other units that have similar figures? Is he aware that there are reports of surgeons being anxious about providing data for fear of reprisals? Is there not an urgent need for the Independent Reconfiguration Panel to report to resolve the uncertainty that exists across the country with regard to children’s heart surgery? Is it not time to give serious consideration to the proposal that both Leeds and Newcastle should stay open, which is supported by clinicians and patients as it is in their best interests? Finally, will he pay tribute to the staff and patients at Leeds, who have acted with great dignity in the face of hostile criticism?

I do pay tribute to the staff at Leeds and to the families of patients. I recognise that this is an issue of huge concern. As my hon. Friend rightly says, they have behaved with great dignity in a difficult situation. I also pay tribute to him for the responsible way in which he has behaved in this difficult situation, as have many Leeds MPs.

My hon. Friend will understand, given that the NHS nationally was provided with data that suggested that mortality could be up to 2.75 times greater at that unit and given that there was a potentially busy holiday weekend ahead, when it did not know how complex the cases would be and when there were locums on the staff rota who may or may not have been up to the standard of the permanent staff, that Professor Sir Bruce Keogh had genuine concerns that led to his decision. But I hope the fact that surgery was restarted on 10 April will assuage my hon. Friend’s worry that the initial decision was linked to the Safe and Sustainable review—it was not; it was a concern about patient safety and because that concern has been addressed, surgery has restarted.

There were, however, issues about the quality of the data, which at least in part was because the hospital was not supplying data properly in the way it needed to. That was one reason why the mortality data were not as accurate and good as they should have been. Although I entirely agree that patient safety must always come first, and not NHS or national politics or whatever it may be, that also means that sometimes difficult decisions have to be taken. What happened at Mid Staffs, where we had a big argument about data that meant nothing happened for too long, and what happened originally at Bristol, where up to 35 children may have lost their lives, is a warning about the dangers of inaction. On this occasion, I think that overall the NHS got it right.

First, let me apologise to the House on behalf of my right hon. Friend the Member for Leigh (Andy Burnham) who cannot be here today because he is in Liverpool attending the memorial service for victims of the Hillsborough disaster.

This situation has descended into yet another trademark Government shambles. Just 24 hours after the High Court announced that the decision to close the children’s cardiac unit at Leeds was “legally flawed”, Leeds Teaching Hospitals NHS Trust was effectively instructed to stop surgery. The timing of the decision was strange to say the least, but to quote the head of the central cardiac audit database:

“It rings of politics rather than proper process.”

We now know that the instruction was based on incomplete and unverified data, and that Dr Tony Salmon, president of the British Congenital Cardiac Association, was “very concerned” at the way the data were being used, and that any conclusions drawn from the data were “premature”. The Opposition are therefore pleased that this urgent question has been granted as the House clearly deserves some answers.

First, the Secretary of State needs to outline to the House exactly when he was informed that NHS England had concerns about the centre, and say whether he gave his approval to suspend surgery there. If so, was he satisfied that the data presented were accurate and had clinical support? On the issue of data, why did it take this recent episode at Leeds for the information to be released into the public domain—information that my hon. Friend the Member for Leicester West (Liz Kendall), and others, had asked to be released for some time?

Secondly, does the Secretary of State accept that the suspension of surgery, with all the consequent anxiety that it caused patients and staff, was at best a mistake and at worst an irresponsible and disproportionate action? Thirdly, does he accept that the timing of the decision to suspend surgery so soon after the High Court’s ruling caused a great deal of suspicion in Leeds and gave the distinct impression that it was a political decision and not based on clinical evidence? Finally—this point goes beyond Leeds—the Health Secretary’s record so far has failed to inspire confidence in the process of reconfiguration. Will he therefore conduct an urgent investigation into Leeds and how this happened, and consider what lessons can be learned from this unedifying episode for the children’s cardiac review and future reviews?

We owe it to the dedicated staff who work in our NHS to ensure that whatever disagreements we may have in Westminster, and whatever our politics, we do not hinder their ability to provide high-quality care to patients. We also owe it to patients and their families not to add to the anxiety and stress of undergoing treatment. On both those counts the Government have failed, and I hope that when the Secretary of State returns to the Dispatch Box, he will have the decency to apologise and start answering these very serious questions.

I am afraid the hon. Gentleman has let the Labour party down with the total inadequacy of that response. He spoke of an irresponsible and disproportionate decision, but I ask him to reflect on that as someone who would like to be a Health Minister. Would he seriously have wanted anything different to happen? If the NHS nationally is informed of data that show that mortality rates at a particular hospital could be up to three times higher than they should be, would he sanction the continuation of surgery, or would he say, “We need to get to the bottom of the statistics before deciding whether there will be any more operations”? If he is saying that he would have wanted surgery to continue, I put it to him that he and his party have learned nothing from the lessons of Bristol and nothing from the lessons of Mid Staffs. I did not authorise the decision, but wholeheartedly supported it because it was an operational decision made by NHS England. It is right that such decisions are made by clinicians, who understand such things better than we politicians do.

On reconfigurations, the hon. Gentleman’s party closed or downgraded 12 A and Es and nine maternity units in its period in office. The shadow Health Minister, the hon. Member for Leicester West (Liz Kendall), has said that Labour would not fall into the “easy politics” of opposing every single reconfiguration, but that is exactly what the Opposition are doing. It is not just easy politics; it is what Tony Blair last week called the “comfort zone” of being a “repository for people’s anger” rather than having the courage to argue for difficult reforms.

My right hon. Friend mentioned at the outset of his response three principles, the first of which was to do no harm. Following discussions that he and I have had—I am sure he has had such discussions with our hon. Friend the Member for Loughborough (Nicky Morgan) and no doubt other Leicester and Leicestershire MPs—does he agree that there is a read-across from Leeds to Glenfield, where we have the Leicester children’s heart unit? It is unquestionably a unit of international repute and certainly one of national repute. The death rates for that hospital, which deals with particularly difficult patients and highly complicated operations, are right at the top. I urge him to learn from the Leeds fiasco—I do not put the fiasco at his door—that the Glenfield hospital should be preserved for the good of the nation and of the people of the east midlands, so that we do no harm.

I am grateful to my hon. and learned Friend for his question. I am waiting to hear advice from the Independent Reconfiguration Panel on its assessment of the Safe and Sustainable review. I will wait until I get that advice before making any decisions, and in particular before making any decisions on Glenfield, Leeds or any other hospital involved.

It is important to recognise, however, that there two separate issues: the first is the mortality rates at particular hospitals, but the second is whether we can improve mortality rates overall by concentrating surgery in fewer hospitals. I will wait to hear from the IRP on both before making any decisions.

The Secretary of State will be well aware of the deep disquiet in Leeds about what has happened to the children’s heart surgery unit in my constituency, and I am grateful to him for the conversation we had on Good Friday. Given that the High Court has decided that the decision to close Leeds is unlawful, and given that we have now had it confirmed that the Leeds unit was safe before and is safe still, when will he be able to reassure worried parents of very sick children that the future of the Leeds unit is safe?

I thank the right hon. Gentleman for the constructive conversation we had on Good Friday about what I entirely agree is an extremely difficult issue for the families and for the staff at the LGI. My intention is to try to resolve the matter as quickly as possible. I obviously cannot comment on what view I will take while legal proceedings are under way and while I wait for advice from the IRP, but I agree with him about the uncertainty, which I would like to resolve as quickly as possible. He would want me to be guided by what is in the best interests of his constituents and people across the country who need children’s heart surgery.

I, too, thank the Secretary of State for his private phone call to me, but we should have heard from him on this fiasco before today in response to an urgent question. I have to say that his response has simply not been good enough, considering what has happened. To correct one thing that he said, it was not with the agreement of the LGI that services were suspended. Clearly, Sir Bruce Keogh marched into the LGI at 8 o’clock in the morning and said that if surgery was not suspended, people would be sacked. That was no way to behave even if the data were accurate, but Sir Bruce has now backtracked and admitted the data passed to him by his friend Sir Roger Boyle were not accurate.

The decision to close children’s heart surgery in a safe unit, which is what we now know Leeds always was, puts children at greater risk. To make a decision of that nature that is incorrect is simply unacceptable. Will the Secretary of State do what is now clearly necessary and have a full investigation of this fiasco, including the conduct, judgment and motivations of senior NHS officials involved?

I simply say to the hon. Gentleman that if, as he has alleged consistently in the media, this was some kind of political ploy linked to Safe and Sustainable, we would not have reopened children’s heart surgery in Leeds on 10 April as we did. I spoke to him at the time and told him that it was my hope that operations would be able to resume as soon as possible and that we would get to the bottom of the data to find that the concerns were unnecessary because the unit was safe. In the end, that is what happened.

It would have been utterly irresponsible for Professor Sir Bruce Keogh, in view of the evidence he was faced with—including incomplete data that the hospital had not supplied in the way that it should have done—not to ask the hospital to suspend surgery. That would have been taking a risk with the lives of the hon. Gentleman’s constituents and the people of Leeds in a way that would have been wholly inappropriate. The NHS needs to move in a totally different direction on patient safety, and this is a good example of the NHS medical director behaving promptly and properly in exactly the way he should.

In his opening statement, the Secretary of State mentioned that one of Sir Bruce Keogh’s concerns was the complaints made by families in Yorkshire about the treatment their children had received at Leeds children’s heart surgery unit. If there had been those concerns, does the Secretary of State not think that over the three years of the Safe and Sustainable review at least one complaint would have been made via Members of Parliament in Yorkshire or local media outlets? The fact that no complaints were received over three years surely tells him that generally the families were very satisfied with the way their children were treated. Will he now apologise to the families of Yorkshire for the closure between 28 March and 10 April?

The apology would have been due to those families if Sir Bruce Keogh had not acted promptly in the face of data that showed the possibility of a serious problem at that hospital. He was right to react promptly and to get to the bottom of those data. I put it to the hon. Gentleman that if he had been a Health Minister at the time he would not have wanted the NHS medical director to do anything other than give absolute priority to patient safety. That is what happened. Like the hon. Gentleman, I am delighted that it was possible for operations to resume on 10 April.

However we got to this point, I urge my right hon. Friend—on behalf of one of the leading campaigners for Leeds heart surgery, my constituent Lois Brown—to do everything he can to ensure that we move as quickly as possible to a decision on Leeds, based on the full facts and made in a transparent manner.

I can absolutely assure my hon. Friend that that is my intention. There is legal due process—legal proceedings are under way—and he would want that to be respected. I am also anxious to read and digest the report of the Independent Reconfiguration Panel. I would like that all to happen as quickly as possible within the law, so that we can conclude this matter and remove the great uncertainty that I know is unsettling so many people.

Does the Secretary of State not accept that Sir Roger’s unacceptable remarks, which came 24 hours after the court decision confirmed the review as flawed, unfair and unlawful, have dented severely the credibility of the Safe and Sustainable review in the eyes of the public? The Secretary of State has suggested that he will wait until the configuration board comes back with a recommendation, but does he not think that it would have been better if he had come to the Chamber to tell hon. Members and the public what steps he would be taking to restore credibility to the Safe and Sustainable review?

I think that NHS England has taken firm action: it has said that Professor Boyle will not take any further part in Safe and Sustainable. However, the hon. Gentleman will understand that as the review is currently subject to legal proceedings, I cannot comment any further. As the final decision will end up on my desk, I want to wait until the legal proceedings are complete and I have the report of the IRP to consider before I make that decision. I stress what I said to my hon. Friend the Member for Skipton and Ripon (Julian Smith): I would like it to conclude as quickly as possible. I know that is in the best interests of the people of Leeds.

I thank my right hon. Friend for his statement. NHS bosses are right to take seriously any concerns regarding patient safety, particularly in the light of the Mid Staffs crisis. There has been significant anger and confusion locally surrounding the chaos of the decision to close the unit. Does my right hon. Friend agree that the use of data, which are incomplete and described by the doctors that produced them as not fit for purpose, has led to precipitate and disproportionate actions that have worried patients and their families? We have, after all, a culture in which NHS managers are extremely familiar with handling data. They must have known that precipitate actions would come from looking at leaked partial data.

I entirely understand the concern of families, staff and doctors at the LGI. I simply say to my hon. Friend that the reason the data were not complete was because the hospital had failed to supply them. There is, therefore, an important warning to all hospitals to ensure that they supply accurate and timely information on their surgery survival rates.

Does the Secretary of State still accept the underlying premise of the Safe and Sustainable review, which is that there should be a smaller number of centres of excellence for children’s specialist heart surgery? If he still accepts that premise, will he say something to the House today about his timetable for bringing the issue, which has gone on for 12 years, to a conclusion?

I certainly accept the premise, on the basis of considerable clinical evidence, that for complex surgery greater specialisation leads to higher survival rates. On whether that is the right thing to do in this particular case, I would like to wait for the outcome of the legal process and the advice of the Independent Reconfiguration Panel, but I will just say this: I would like to conclude this as quickly as possible. I am subject, rightly, to legal due process. Families who feel strongly want this to be concluded quickly, but they also want to know that it has been concluded fairly, and I think that that underlies a lot of the concerns raised by Members this afternoon. The timetable is not within my gift but what is within my gift in terms of timings I will try to expedite as quickly as possible.

Does my right hon. Friend recognise that whatever challenge there may be to the evidence relating to Leeds, there has been no challenge to the evidence of the successful outcomes in Newcastle? Can he assure me that clinical evidence will predominate in his final decision?

I can absolutely give my right hon. Friend that assurance. It is very important, when dealing with very difficult decisions of this nature, that we are led by clinical evidence on what will save the most lives. We have an absolute responsibility to all of our constituents to ensure that clinical evidence informs the final decision.

I was contacted by a mother whose son’s operation was cancelled, and it had also been delayed on two previous occasions for other reasons. Given this unedifying situation, in which the two leading clinicians who advise on these areas for the NHS have lowered themselves to saying whether they would send their child to this unit for an operation, what advice should I give to my constituent?

I am certain that the right hon. Gentleman’s constituent would not want surgery to proceed anywhere in the NHS if there are question marks over its safety. Of course, when such decisions are made in a very short period of time, it is greatly discomfiting and worrying for the many families involved, who have enough to worry about anyway—I completely understand that. He should remember, however, how we in the NHS let down the families in Bristol and Mid Staffs by not acting when data suggested that there might be a problem. It is better to act quickly and decisively and then, if possible, to resume surgery, as happened on this occasion, than not to act at all and to find out later that we have been responsible for much, much worse outcomes.

On behalf of right hon. and hon. Members across Yorkshire, may I use this opportunity to thank my hon. Friend the Member for Pudsey (Stuart Andrew) for how he has worked in a consensual, cross-party and non-political way on this issue?

Did the Secretary of State not find it at least odd that the concerns about the Leeds unit came to light within hours of the High Court’s ruling against the decision to close the Leeds unit?

Whenever he receives information, the medical director is under an absolute obligation to act. What he did was absolutely correct: he said that he would look at the data and get to the bottom of them and that if it turned out that the data were not as accurate as they should have been, surgery would resume. That is exactly what happened.

The hon. Member for Kingston upon Hull East (Karl Turner) is a very excitable fellow—he might remind some people of his predecessor in the House in that respect.

A baby born with a heart condition in Sheffield who needs a complex intervention would normally go to Leeds. One of the concerns about the Safe and Sustainable review was that children from my constituency would have had to travel further. The decision to suspend the Leeds unit created that very situation. The Secretary of State needs to acknowledge that children could, as it turns out, have been put at risk unnecessarily by closing a unit that was in fact safe, because they would have had to travel further, which for very ill babies is a risk in itself. At the heart of this has been a lack of transparency and a failure to put information into the public domain. I have had to table parliamentary questions to try to get information about what is happening. Nobody wants an unsafe situation. Will the Secretary of State now commit to complete transparency in respect of all the information?

This situation arose because of the much greater data transparency and because the Government have been encouraging people to come forward if they have concerns about things going wrong. As a result, we were presented with data on the basis of which the NHS director decided that the safe and sensible thing to do was to suspend surgery while we got to the bottom of these data, which could have demonstrated some very serious outcomes. We need to take good advice from clinicians about the balance of risk. Yes, there might be some risks with people having to travel further for the surgery, but surely the risks are much greater if potentially unsafe operations are allowed to continue. That was why, on that balance of risk, it was decided to suspend surgery at Leeds until we could get to the bottom of whether the data were right.

In the week after surgery at the heart unit was suspended, my wife and I met a constituent in Rothwell whose child was due to go in for surgery. She was completely and utterly exhausted and overwrought with worry and concern. Many people were concerned not just about the suspension, but about the distances that they would have had to travel if Leeds had not reopened. That possibility, which we had previously mentioned, became a reality. Sir Roger has now been suspended from the review, but he had already reported. In order that we can take one positive out of what has happened in the past couple of weeks, will the Secretary of State ensure that the distances people have to travel are now taken seriously in the review?

That is exactly the purpose of a review. Let me reassure my hon. Friend that before I make any decision, I will be getting on my desk independent advice from the Independent Reconfiguration Panel. One thing that that advice does is weigh up the balance of advantage between the greater distances that people have to travel and the advantages of specialisation for complex surgery. My heart goes out, as I know his does, to people who were made extremely worried by what happened over Easter at Leeds. However, he will also understand that if there are concerns, the last thing his constituents would want is an NHS that did nothing because of an argument about data. The right thing to do was to get to the bottom of the data, and I am sure that his constituents are as delighted as he and I are that surgery has now resumed.

What does the Secretary of State think of the opinion of one of my constituents, who said to me over the weekend, “What a right old mess all this has been”? The fact is that it has been a mess. I have supported the all-party campaign on the basis that we go for the best clinically safe outcomes for all my constituents. My constituents have gone to Leeds general infirmary, as have my children. It is a hospital of great renown, in which the people of Yorkshire have tremendous faith, but in today’s statement the Secretary of State has two or three times put us in the same frame as Mid Staffordshire and Bristol. There is no question but that Leeds general infirmary is a fine institution. Will he put it on the record today that this is not the same sort of case? This is a fine hospital struggling to deliver under a cloud that has been over it for three or four years.

What I say to the hon. Gentleman is that it is a fine hospital and a safe hospital, but data were presented to the NHS medical director that said that mortality rates there for children’s heart surgery were two and three quarter times higher than should be expected. In that situation, there is of course a great deal of inconvenience and worry caused by a decision to suspend surgery, but I would rather have that inconvenience and worry than continue with surgery when we have not got to the bottom of whether there is any truth in those data. That must be the right thing to do for the people who are due to have operations at that hospital.

Parents whose children face major surgery are already particularly anxious and distressed, and that is before an unseemly public dispute breaks out between the medical experts that they rely on. This also highlights the fact that the investigation has been going on for far too long. The uncertainty is unacceptable. May I urge my right hon. Friend to do everything possible to bring the matter to a speedy conclusion?

I completely agree with my hon. Friend. I want this to be resolved as quickly as possible. We have to operate within legal due process, but the sooner we can resolve the uncertainty, the better.

I know the Secretary of State likes dancing, but his fancy footsteps today are doing him no favours. The position in Leeds is that the public have lost confidence after what has taken place. Sir Roger Boyle has condemned the hospital and the Secretary of State has not condemned him for the comments he has made. Can he do that now?

Let me be clear: I do not want anyone in the NHS who has concerns about mortality to sit on those concerns, so if Sir Roger had concerns, he was right to raise them with Professor Sir Bruce Keogh. Sir Roger also made comments that suggested that he might have prejudged the outcome of Safe and Sustainable, so I think it is right that he does not take any further role in that, and we will be getting independent advice on whether Safe and Sustainable made the right recommendations, which I shall consider before making any decision. I have to say to the hon. Gentleman that there is no fancy footwork. I am absolutely clear that if anyone, anywhere in the NHS, has concerns about safety and if the view of the NHS medical director is that we need to investigate those concerns and, in the meantime, suspend surgery at that institution, I will support the NHS medical director. That is the right thing to do and I think the hon. Gentleman would do exactly the same if he were in my shoes.

This whole thing stinks; it really does. We now know that the unit is perfectly safe, which means that, for a period of time, children’s health was put at risk while it was closed. That is the seriousness of the situation. The decision was not made after careful, thoughtful consideration of authoritative, verified data; it was a kneejerk reaction to what must, in all probability, have been malicious allegations made against the unit. We have been told over and over again to ask ourselves what Sir Roger could have done, other than close the unit, but what did he actually do? That is what we need to find out, and the matter needs to be investigated. We know what the context was, following the court case, and we need to find out what follow-up work he did in that context to verify the allegations before he took that risk with the health of young children.

There are some risks, of course, in suspending surgery, but when we have mortality data such as those that Professor Sir Bruce Keogh was faced with, there are also considerable risks involved in doing nothing in response. The decision was taken not to close the children’s heart unit but to suspend surgery until he could get to the bottom of whether there was any truth in the data. He had a very difficult decision to make, given that situation, but I think he made the right decision.

Parents of very poorly children in the Scunthorpe area who have been very effectively supported by the Leeds unit have been dismayed to hear what has been happening over the past month or so. The Secretary of State has given us clear answers this afternoon, and I thank him for that. He has said that there will be a resolution to the Safe and Sustainable review as soon as possible. Will that be in 2013 or at some point beyond that?

I very much hope that this does not go beyond 2013, but I am afraid that that is not in my hands, because of legal due process. Legal proceedings are under way at the moment and I have to consider the advice of the Independent Reconfiguration Panel, but I want to stress to the hon. Gentleman, as I have to many hon. Members, my determination to resolve the situation as quickly as possible.

Children living in Thirsk and Malton will be operated on either at Leeds hospital or at Newcastle hospital. What is becoming apparent in this and other debates on the health service is the desire of parents and other family members to have their loved ones—young children in this case—operated on as close as possible to where they live, whereas clinicians and the Government seem, at every stage of the NHS reforms, to be making decisions based on clinical excellence. This is a debate that needs to be had.

I agree with my hon. Friend. There are two types of reason for people going into hospital. With geriatric care, for example, there are clear advantages in someone being treated as near as possible to their home. All other things being equal, it makes sense for people to be treated where it is easy for friends and family to visit them, as that can aid recuperation and convalescence. When more complex surgery is required, however, there is clinical evidence that mortality rates are better if we specialise surgery in a fewer number of centres. That is the debate that we are having about children’s heart surgery, and I hope to resolve the matter as quickly as possible.

Given that the Safe and Sustainable review is being dogged by so many problems, and given the inaccuracies and the prejudice against Leeds in particular, has the Secretary of State thought about scrapping the whole process?

That is the subject of legal proceedings at the moment, and I want to ensure that we have a process that is fair and that is recognised to be fair by all the people who are affected by this possible decision. I therefore want to ensure that the decision will be judicially robust, but I also want to get independent advice from the IRP before I make my final decision. If that means that it takes longer to get to a decision, then I am afraid that that might be the case, but the most important thing is to get to a decision that is fair and that is recognised to be so.

It is right that such decisions should be made on the basis of data, but those data must be more reliable. Such decisions are made in this way up and down the country on maternity and accident and emergency units, for example. How will the Secretary of State ensure that such data are reliable and robust, that they can be challenged, and that such situations can be dealt with far more quickly than has been the case in Leeds?

The hon. Lady makes an important point. At the heart of this is a change happening in the NHS, where heart surgery is leading the way and we are discovering that we can make dramatic improvements to mortality rates. It has happened in heart surgery, where we have moved from being one of the worst performers in Europe to one of the best, because of the collection of risk-adjusted data. That has now been extended to cancer outcomes and to a total of 10 specialities. We shall gradually collect those data over the next two years, which will allow peer review in a way that cannot normally happen. It is a big change and part of the issue was that the hospital in Leeds did not realise how seriously the data would be taken, which may have meant that it did not supply as complete data as it should have, and that led to the problem. There is a big change, but also a big opportunity for the NHS to improve its outcomes.

I want to reinforce entirely the point put to the Secretary of State by the hon. and learned Member for Harborough (Sir Edward Garnier) a few moments ago. Safe and Sustainable made recommendations about Leeds and about closing children’s heart surgery at Leicester, but in recent days published data show that Leicester has one of the lowest mortality rates. Can the Secretary of State guarantee that the Independent Reconfiguration Panel will fully take into account those data published just a few days ago?

We have seen an extraordinary sequence of events that have unnecessarily tarnished the reputation of what the Secretary of State described as a fine hospital, and caused enormous anxiety to families across Yorkshire and the wider region. Does the Secretary of State not agree therefore that we need a full inquiry into how the decision was taken?

I think the most important thing is properly to establish the truth of the data and then to make sure that any lessons learned from that are reflected in decisions made about the Safe and Sustainable Review, so that the influence of mortality data on any decisions in Safe and Sustainable is based on proper analysis of those data. That is certainly something we will learn from.