Children’s heart operations in Ireland will be delivered on a cross-border basis from a single surgical centre in Dublin, Stormont’s health minister has confirmed.
The all-Ireland clinic network approach was proposed by Jim Wells and Minister for Health Leo Varadkar, in the autumn.
The go-ahead had been dependent on the outcome of a public consultation exercise.
With all responses received and assessed, Mr Wells this morning told the Assembly that he and Minister Varadkar were content to give the plan the green light.
While scheduled surgical services will cease in Belfast, a cardiac centre of excellence will be set up in the city to provide diagnostics and after-care to northern-based children with congenital heart defects.
The single all-Ireland surgical unit will be based in Our Lady’s Children’s Hospital at Crumlin.
The plan is in line with recommendations made by an international working group (IWG) commissioned to examine children’s cardiac services in Ireland by Mr Wells and Mr Varadkar’s respective predecessors, Edwin Poots and James Reilly.
The IWG concluded that the relatively few cases of congenital paediatric heart disease in Ireland could not justify the operation of surgical centres on both sides of the border.
Mr Wells told the Assembly: “It is clear from the public consultation that there is significant support in the community for the model recommended by the IWG and acceptance of paediatric congenital cardiac surgery ending at the Belfast Trust.
“When I read the IWG’s report last October my instinct was that their proposed model was the right way forward for these vulnerable patients and their families.
“However, I wanted to give them, the clinicians who provide this important service and the public the opportunity to have their say.
“While I fully understand the concerns expressed about the ending of surgery in Belfast we really had to accept this given the overwhelming clinical evidence that we simply do not have sufficient numbers of patients to meet the very rigorous international standards required for the treatment of this condition.
“The model proposed by the IWG means that these children will have their surgery in Dublin within a reasonable travelling distance from their homes with their pre and post-operative care being delivered in Belfast.
“Therefore having fully considered the outcome of the public consultation I confirm my acceptance of all of the IWG’s recommendations and reaffirm my commitment to work with Minister Varadkar on their full implementation.”
There is already significant cross border co-operation in children’s cardiac care, with surgeons from Dublin travelling to Belfast to perform non-complex procedures.
Complex operations stopped in Belfast around two years ago, with many children having to travel to England for surgery.
The new plan envisages that all children on the island of Ireland should have surgery in Dublin.
The report from the working group, chaired by John Mayer from Boston Children’s Hospital in the US, was the fourth study on the issue to recommend a single surgical unit in Dublin.
Around 140 children a year from the North require heart surgery. In the Republic of Ireland the number of cases is around 400.
Mr Wells has vowed that a number of measures will be implemented to address concerns of northern-based families, such as the upgrade of paediatric transport services between Belfast and Dublin.
The two ministers have published a joint statement setting out the governance arrangements for the new clinical network, which will be established at the start of April.
This is comprised of a cross-jurisdictional oversight group and all-island clinical network board.
The board will be chaired by Len O’Hagan, chief executive of the Royal College of Physicians of Ireland.
Mr Wells said there would be an interim period of 15-18 months while the new model works up to full capacity. In that time existing arrangements, including the reliance on surgery in England, will continue.
The minister concluded: “This presents a tremendous opportunity to build on the respective strengths of the children’s heart centres in Belfast and Dublin through the creation of a service which I believe has the potential to provide world class facilities, services and outcomes for these vulnerable children and their families from across the island of Ireland.
“This is a prize to be strived for and I send my best wishes to the clinicians, managers and family representatives who will work together to deliver the new service model.”