Top surgeon's lifeline to heart unit

The head of one of the UK's leading heart transplant units has offered his services to revive Scotland's beleaguered cardiac service.

John Dark, consultant surgeon and head of the transplant unit at the Freeman Hospital in Newcastle, has offered to help train up surgeons to perform transplant operations in Scotland. He has also offered to travel north of the Border to assist in the first operations carried out at the unit if it is reopened next year.

The firm offer of support and assistance is a vote of confidence in the future of the Scottish unit. But Dark says the unit will only survive if the enthusiasm which has been lacking from the trust up until now is found.

He said: "It is crucial now that the unit is put on a proper footing and that there are enough enthusiasts. This has not been the case at Glasgow Royal Infirmary up until now."

His thinly veiled criticism of the management of the unit has been expressed more openly this weekend by the founder of the unit.

Professor David Wheatley, who is now head of cardiac surgery at Glasgow University, claims the unit could reopen immediately if managers stopped dithering about appointing transplant surgeons.

He said that over the last few years, two surgeons had been sent to Australia for training. He added that another two who had worked at the transplant centre at the Freeman Hospital were now back in Glasgow and would have little difficulty refreshing their skills before taking up positions at the Scottish unit.

But he said he had no confidence that the trust could solve the unit's problems.

He said: "I am very much afraid that the suspension will turn into a permanent thing. People will become deskilled, grow disillusioned and move away.

"The rate at which the administration has responded to the problems gives me no confidence that they will come up with a viable solution in the next year."

A government review of heart transplant units in England is expected to recommend concentrating services in a smaller number of hospitals.

The Royal College of Surgeons has pointed out that for units to be efficient they should have four heart transplant surgeons, each carrying out 10 transplants a year.

But Dark believes that, as Scotland already performs around 30 heart transplants a year, the unit at Glasgow Royal Infirmary is "almost viable", providing there is enough enthusiasm behind it.

He points out that the number of transplants carried out in Scotland matched the average for other UK centres and insists that the results from the Scottish unit were just as good as other hospitals in the country.

He said: "There is the expec-tation that some of the English centres will close because a number of the units fall short of the College of Surgeons recommendations.

"The question is can you accept a slightly unsatisfactory situation where Scotland is not quite big enough, but this is worth tolerating to provide a good service to the patients in terms of the geography.

"In the last eight years it did not sustain itself because of lack of manpower but the outcomes were very good. In clinical terms they offered a very good service. It was just not well enough organised. What is crucial now is that there are enough enthusiasts to make this work."

And Dark promised that he and his team in Newcastle will do all they can to help set up a proper service in Scotland.

He said: "Given that the political decision has been taken that there should be one in Scotland, we will do everything we can and we would help to set up the unit.

"We can offer training for nurses and surgeons. We could also arrange support for when they first restart doing transplants. We can also offer assessment prior to and after treatment. We could be formally available to advise. We have had a number of discussions with the trust."

North Glasgow University NHS Trust was forced to announce the temporary closure of the Scottish Heart Transplant Service at the Glasgow Royal Infirmary earlier this month following the resignation of its only heart transplant surgeon, Surendra Naik.

Naik has given up his post at Glasgow Royal Infirmary to take up a new job at Nottingham City Hospital. NHS trust bosses have so far failed to find a replacement, forcing the unit to be mothballed for at least a year.

The offer of help was last night welcomed by the British Medical Association.

Dr Bill O'Neill, Scottish secretary of the British Medical Association, said: "It is reassuring that the Newcastle team is keen for the unit in Glasgow to continue and that they are offering support."

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