Dr Stephen Bolsin, former consultant anaesthetist at the infirmary, told the public inquiry into the disaster that he believed managers and doctors at the infirmary were anxious to maintain the hospital's designation as one of 12 specialist units for children's heart surgery in the country, and that this lay behind their refusal to investigate his concerns about the high death rate.
Dr Bolsin, who is credited with exposing the disaster, choked back his tears as he paid an emotional tribute to the children who died before the four-member inquiry panel.
Watched closely from the crowded public gallery, which contained a number of parents who lost children in the tragedy, he said: "I wanted to say that I sympathise enormously with the parents ... I wanted to let them know that for me they were all individual children who had families. I am very sorry for what happened."
Earlier, Dr Bolsin came under tough questioning from the inquiry's counsel, Brian Langstaff, QC, who questioned his motives for exposing what was going on at Bristol. Mr Langstaff accused him of demanding money from the United Bristol Hospitals Trust, to keep quiet about the high death rate, but Dr Bolsin denied the allegations.
Dr Bolsin had described a conversation with the head of the anaesthetics department, Chris Monk, in which they had considered whether the unit could be stopped from carrying out high risk operations. Dr Bolsin said senior staff had wanted a review that would not interfere with their work.
He said: "The analogy that was used was of a train where occasional passengers were falling off, and the train had to keep moving in order to attract funding. That was one of my concerns about the subjugation of patient safety by reasons of funding and continued activity in high risk areas. My impression of this unit was that the commitment of staff was to keep doing the things they felt were important to designation, irrespective of risk to patients."
Dr Bolsin had joined the infirmary in 1988 from the Great Ormond Street Hospital, London, but by 1992 he had decided that he wanted to leave. Relations between him and the two surgeons James Wisheart and Janardan Dhasmana broke down after Dr Bolsin raised concerns about the high death rate for some operations. The three even received counselling from psychiatrists to try to resolve their differences. Dr Bolsin tried but failed to get a job elsewhere until he was offered the post of head of anaesthesia at Geelong hospital in Victoria, Australia.
He admitted that he had considered making a claim for constructive dismissal against the hospital, but he denied that he used this potential claim, and a projected television programme, as threats to pressurise the board into making ex-gratia payments.
Mr Langstaff asked: "You were putting a gun to the head of the Trust and saying 'pay me or I will go public?"' Dr Bolsin replied: "That is not the way I saw the request I was making. It was a perfectly human reason for compensation for the disruption to my family life."
Dr Bolsin flew to Britain with his family last weekend to give evidence at the public inquiry, and is expected to be on the witness stand for four days.