NI children's heart surgery 'should move from Belfast to Dublin'
Children from Northern Ireland who require heart surgery should receive treatment in the Republic of Ireland as opposed to the current facility in Belfast, it has been recommended.
The move follows a report that said that, while safe, the service at the Royal Belfast Hospital for Sick Children is no longer sustainable.
The decision was announced at a public meeting on Thursday.
The report says children who require surgery should now travel to Dublin.
For the past 12 months parents and members of the Children's Heartbeat Trust have campaigned vigorously for the retention of children's heart surgery in Northern Ireland.
Last year a national report said that such centres across the United Kingdom must perform a minimum of 400 children's surgical procedures each year.
Belfast currently falls short of that number.
A working group now recommends an all-island service. Children who require surgery will be expected to travel to Our Lady's Children's hospital in Crumlin, south Dublin, instead.
Birmingham had also been cited as an option.
Approval of the recommendation by health ministers in Northern Ireland and the Irish Republic is expected to be a formality.
A father from Northern Ireland, whose son received heart surgery at Our Lady's Children's hospital in Crumlin this week, has said he believes some level of surgery should be retained in Belfast.
However, Aidan Kearney said he would choose Dublin in comparison to travelling to England.
He highlighted the benefit of children having heart surgery in Belfast.
"A child was only born a week ago, had surgery in Belfast and then was transferred down here (in Dublin) for their major surgery, without surgery in Belfast the child would not have survived," he said.
Dr Paul Oslizlok, a paediatric cardiologist at Our Lady's Children's Hospital, Crumlin, said he understood some parents in Northern Ireland might be concerned if a situation developed late at night that required them to travel to Dublin for surgery at short notice.
However, he said he believed the facilities were in place to deal with such a scenario.
"We had an example recently where a baby became critically ill in Belfast and I think it was around 10 or 11 o'clock at night, one of the doctors rang us here," he said.
"That baby who we were phoned about at 10 o'clock was actually in the operating room here receiving care one and a half hours later, that is pretty quick and I think so long as we have the transport mechanisms properly worked out, we have proper care pathways.
"The key thing is to have the critical person, the cardiac surgeon available with the expertise required, every hour of every day of every year and that's available here and can only be available I think at a large centre.
"That baby was transported by road by a specific ambulance, expertly done, with two consultants, they gave care to the baby and the baby was brought right from the ambulance right up to theatre."
He also said there were skilled paediatric cardiologists and cardiac surgeons in Belfast and that it would be "unthinkable" not to use their resources and their experience.
"I think the care we would envisage would involve both Belfast and Dublin," he added.
Northern Ireland's health minister, Edwin Poots, told the BBC: "I think today is very significant in that the notion that we would move children's heart services to England has gone and that is a very positive step."
He said he believed the families affected would "welcome the fact that we're now talking about Dublin and not Birmingham".
However, Mr Poots said he still had "issues and concerns" about the recommendations made by the working group. He said there was a "weakness" in the proposals in respect of newborn babies who required heart surgery.
The Stomont MLA said he was due to meet the Irish health minister about the surgery changes and would try to make special arrangements for newborns.
"I think that some of those children wouldn't be in a very fit state at that point of time and therefore the movement may not be suitable and I want to see what the possibilities are of actually bringing the surgeons to Belfast to carry out those operations."
Mr Poots added that it was "an impossible ask" to retain full children's heart surgery in Northern Ireland because the number of procedures carried out annually was hundreds short of what is required for a sustainable service.
"It's not within my gift and it never has been within my gift because it would be extremely difficult - it would be impossible - to attract the surgeons to Northern Ireland to carry out this work. So it is important that we arrive at a situation with Dublin that is a networked situation and see if it can enable us to carry out some form of surgery in Belfast."
Irish health minister James Reilly told the BBC on Thursday that it was important to himself and the Northern Ireland health minister that they "improve the outcomes of patients".
"I'm certainly quite happy that we have the capacity here in Crumlin to be able to look after children from the north of Ireland and I'm very pleased to say that in other areas there is a great deal of co-operation as well," he added.
"When it comes to national health issues I think we tend to put politics aside to get a better outcome for our patients.
"We will be looking to facilitate this in every way."