Dr John Roylance told the Bristol public inquiry into the disaster that responsibility for maintaining standards of care in the hospital lay with the consultants and that it was for the royal colleges to handle problems of competence among them. Where concerns arose it was for the consultants to report them to management. "How else could management know?" he asked.
Dr Roylance was found guilty of serious professional misconduct, along with surgeons James Wisheart and Janardan Dhasmana, after a General Medical Council investigation last year into the cases of 53 babies who underwent heart surgery at the infirmary, of whom 29 died. As chief executive, Dr Roylance was found to have ignored warnings about the surgeons' high death rate.
Yesterday he appeared before the four-member panel under chairman Professor Ian Kennedy to give background details of the management of services in Bristol which the public inquiry is probing in the 12 years to 1995.
Dr Roylance said that questions about the competency of medical staff were not for managers and that "health care was led by consultants". He added: "That was not something I imposed. It was my recognition of reality. I recognised it was impossible for managers to interfere." Challenged that it was his view that it was for doctors to identify failings in doctors, he replied: "It was not my view, it was the view."
Last month, Richard Lissak QC, counsel for the parents whose children died or were brain damaged, told the inquiry that his clients strongly suspected that there had been a cover-up involving the Royal College of Surgeons, the Department of Health and the hospital, who he says knew of the problems by July 1992 but did nothing. Over the next three years, at least a further 44 children died.
The inquiry, which began public hearings in March and is continuing, has heard that concerns about the high death rate at Bristol were raised as long ago as 1986, two years after it had been designated a specialist centre for paediatric cardiac surgery.
A hospital inquiry was launched yesterday after a one-and-a-half inch hypodermic needle was allegedly left inside a baby during a check- up.
Seventeen-month-old Casey-Jane Angel was taken to the Royal Hampshire County Hospital in Winchester after her mother, Alison Angel, 34, noticed blood spots in the baby's nappy. An X-ray revealed a piece of metal embedded in her kidney, which her parents believe could have been there for as long as nine months.Reuse content