James Wisheart, paediatric cardiac surgeon and former medical director of the infirmary, appeared nervous and uncertain as he took the witness stand for the first time in the longest running disciplinary case in British medical history. He is charged, with two colleagues, of allowing operations on children with complex heart defects to continue after the high number of deaths indicated they should have been stopped. All three deny the charges.
Outside the council's London headquarters, parents of the children who died, who had travelled overnight from the West Country, held a silent candle-lit vigil with tiny black coffins at their feet representing the lives lost. Malcolm Curnow, spokesman for the Bristol Heart Children Group, said: "Up to 1,000 children have been exposed to unnecessary risk during the period currently under investigation by the GMC. But the doctors who run the GMC are only looking at two types of operations in a restricted five-year period. We have had enough of secrecy. We need an independent public inquiry to establish the full scale of the horror story."
Inside the hearing, Mr Wisheart, 59, clasped his hands in front of him and darted occasional quick glances at his counsel as he answered questions about his team's surgical record.
There were 29 deaths among 53 children who underwent surgery. Speaking slowly and carefully, with frequent pauses, Mr Wisheart told the council that he had kept records of the operations from the start of his employment at the infirmary in 1975 and had begun tabulating the results, to make comparisons easier, from the mid-Eighties.
He said the surgical team met twice a week to discuss individual patients, and, from 1986, further meetings were held with pathologists to discuss any patient who died. In addition, all the specialists involved met two or three times a year in the evenings in someone's house to review their performance and discuss problems and future strategy.
"The quality of the work being done nationally and internationally was constantly improving and one had to keep up with that," he said.
The disciplinary hearing, which began in October and is not expected to end until April, breaks new ground for the GMC. Mr Wisheart and his co-defendants, cardiac surgeon Janardan Dhasmana and trust chief executive, John Roylance, are charged with serious professional misconduct, the first time such a charge has been brought over a complex issue of the risks and benefits of medical or surgical treatment. Normally such charges are levelled for clear breaches of professional ethics such as having a sexual relationship with a patient, misprescribing controlled drugs or refusing to visit a patient.
The Bristol Heart Children Group, set up by campaigners representing 68 children who died or who were brain damaged at the infirmary, said that the GMC had refused to include adults in its investigation and had limited it to two procedures over a limited period from 1990 to 1995.
"We believe this hearing is not fair, not thorough and not complete," they said.
In a statement the GMC said the case had been brought after an extensive investigation which concluded that questions of serious professional misconduct arose only in relation to the question of whether the defendants should have acted on warnings from colleagues about the high death rate.
"Although we are sympathetic to the tragedies which many of the parents in this case have experienced, the GMC does not have legal powers to investigate wider organisational issues nor to offer individual patients personal redress."Reuse content