Annex A > Chapter 10 - Outreach Cardiology Clinics > Clinics in the South West and South Wales
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Clinics in the South West and South Wales
`When I started in Bristol in 1980, Dr Jordan had already organised the "outreach" or peripheral clinics throughout the South Western Region and South East Wales. Between the two of us, we continued to provide clinics in Gloucester, Cheltenham, Swindon, Bath, Newport, Taunton, Barnstaple, Exeter, Torbay and Truro, with occasional visits to Plymouth.' [8]
10 Dr Stephen Jordan, consultant cardiologist, explained the arrangements that had existed in the South West, basically unchanged, since 1984. He said:
`All other hospitals in [the South West] Region with the exception of Yeovil were visited on a regular basis by one of the cardiologists doing a cardiological clinic, usually with one or more of the paediatricians and typically occupying all day once a month. Plymouth was otherwise the only exception as I visited only once or twice a year and the other clinics there were done by consultants from Southampton.
`The clinics in [the South West] Region were: Cheltenham, Gloucester (Dr Martin, morning and afternoon respectively), Taunton (Dr Jordan, all day), Exeter (Dr Martin, all day), Torbay (Dr Joffe), Plymouth (Dr Jordan, afternoon), Truro (Dr Jordan, all day) and Barnstaple (Dr Martin, afternoon or all day).' [9]
11 Dr Joffe charted the development of the outreach clinics in Wales in his statement:
`In the mid 1980s, several local consultant paediatricians in South Wales individually approached the Bristol paediatric cardiologists to request that Bristol provide a "regional" paediatric cardiological and cardiac surgical service for their patients. The paediatric departments had loosened their connections with London centres through, for example, retirement of the visiting paediatric cardiologist from Hammersmith; a specifically paediatric cardiac surgical centre in Wales did not then exist. ...
`The additional peripheral clinics were started in Abergavenny in 1986, in Swansea, Carmarthen, Haverford West and Merthyr Tydfil in 1987, and in Neath and Bridgend in 1989. These clinics have continued successfully until the mid-1990s. With the establishment of the Cardiff paediatric cardiology and cardiac surgery unit, some paediatric departments have established a connection with Cardiff. Abergavenny, Bridgend, Neath and Swansea have maintained a relationship with Bristol until today.' [10]
12 Dr A Palit, a consultant paediatrician at Pembrokeshire and Derwen NHS Trust in Wales, told the Inquiry that the:
`... decision to send our children to Bristol was very easy because there were no other centres nearby us, who could give us a regular service. After the death of Dr L G Davies, I approached Dr Steve Jordan (a very eminent Paediatric Cardiologist), who was extremely helpful and supportive and offered his services immediately.' [11]
13 Dr Jordan confirmed that in a number of places in Wales, Dr K Hallidie-Smith had conducted clinics from Hammersmith Hospital and that on her retirement Bristol took over a number of her clinics. [12]
14 As to the clinics run by Dr Leslie Davies, Dr Jordan said that Bristol started to pick up some of his work before he died, because what paediatric cardiac surgery there had been at that time in Cardiff had stopped before then. [13]
15 Dr NK Agarwal [14] explained how, in 1982 or 1983, at the suggestion of a colleague, he transferred a premature infant from Swansea to the BRHSC. He said:
`Until this time, to my knowledge no paediatric cardiac patients had been sent to Bristol, however from this time onwards myself and my colleagues in Swansea started to send children requiring cardiac care to Bristol cardiologists ... After the death of Dr L G Davies ... I persuaded Dr Hyam Joffe ... to hold regular clinics with us in Swansea starting some time in 1986.' [15]
16 Dr Baker noted that the paediatricians working in Dr Davies' health authority, that is Gwent Health Authority:
`... found referral to Bristol as being effective and a good service ...
`The Chief Administrative Medical Officer for Gwent, Dr Harrett offered honorary contracts to Drs H Joffe and S Jordan for clinics in Gwent.' [16]
17 Dr Jordan said that in South Wales the Bristol cardiologists visited clinics:
`... in Newport (Dr Jordan, afternoon), East Glamorgan (Dr Jordan, all day), Swansea (Dr Joffe, all day), Bridgend (Dr Martin), Carmarthen (afternoon, Dr Jordan) and Haverford West (Dr Jordan, morning or all day).' [17]
18 There was some correspondence on the cost of running such clinics. For example, in a letter dated 24 February 1987 to Ms Jerrard, in the Medical Personnel Department at District Headquarters, Dr Jordan discussed the clinic at Newport in Gwent Health Authority. He wrote:
`In general the main effect of this clinic will not be to increase the numbers of patients being treated in Bristol but to avoid travelling for children and their parents. However, I think it does underline the necessity for the Bristol and Weston Health District with the South West Regional Health Authority to ensure that the financial arrangements with the Welsh Office are adequate.' [18]
19 Later that year, on 8 May, Dr Baker said in a letter to Mr Wisheart, Mr Dhasmana, Dr Jordan and Dr Joffe:
`... several London hospitals as well as Southampton, have cardiologists who are active in holding clinics in South and Mid Wales and referring patients to their own centres for cardiac surgery. Unless the Welsh Office and the constituent authorities decide where they wish to spend their resources and organise the referral patterns through the relevant cardiologist, then we cannot be confident about the volume of service which will be required from our units here in Bristol. If this is not agreed, then we cannot sensibly determine the implications for our services in terms of space and staffing nor can we make appropriate charges upon the Welsh Office or any other DHSS funding source to cover the costs of the service.' [19]
20 The Bristol cardiologists also conducted clinics in the West Glamorgan Health Authority and the Mid Glamorgan Health Authority. [20]
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Footnotes
[8] WIT 0097 0142 Dr Joffe
[9] WIT 0099 0015 Dr Jordan
[10] WIT 0097 0143 Dr Joffe
[11] REF 0001 0092; letter from Dr Palit to the Inquiry
[14] Consultant paediatrician, Singleton Hospital, Swansea
[15] REF 0001 0085; letter from Dr Agarwal to the Inquiry
[16] WIT 0074 0022 Dr Baker
[17] WIT 0099 0015 Dr Jordan
[18] WIT 0074 0449 Dr Baker
[19] UBHT 0092 0002; letter from Dr Baker dated 8 May 1987
[20] WIT 0074 0024 Dr Baker