Ministers have pledged that an independent inquiry will follow the General Medical Council hearing which last week exposed the role of the two surgeons, James Wisheart and Janardan Dhasmana, at the centre of the tragedy. The inquiry, which parents are demanding should be held in public, will consider why other consultants at the hospital continued to refer patients to Mr Wisheart and Mr Dhasmana, and to work with them, when they knew that their death rates were high.
Yesterday, Dr Stephen Bolsin, the consultant anaesthetist who raised the alarm about Bristol's poor safety record in 1988, was reported to have said he was prepared to name at least four other anaesthetists involved in the fatal operations.
Dr Bolsin, who claims he was ostracised by the NHS after blowing the whistle on his colleagues and who now works in Australia, said he was prepared to return to Britain to give evidence. "I will have no difficulty in naming them," he said.
Mr Wisheart and Mr Dhasmana were last week found to have carried out complex heart operations on babies between 1988 and 1995, ignoring repeated warnings from colleagues, when they should have known that their poor success rate was putting lives at risk. Dr John Roylance, former chief executive of the hospital, was found to have failed to prevent the operations going ahead.
The seven-month hearing, the longest on record, has been adjourned until mid-June when it will consider whether the facts proved amount to serious professional misconduct. All three doctors deny misconduct.
In the case of Matthew Rundle, one of the last babies to be operated on by Mr Wisheart for a hole in the heart - who died a week later - the GMC found that the surgeon had not only ignored warnings but had also told Matthew's mother, Sandy, that risks of failure were 20-25 per cent, when his own record showed they were at least twice that.
Yesterday, Mrs Rundle said: "I find it so hard to believe that four doctors warned him not to do it and yet he went ahead. I certainly could not forgive him now I know I was misled. I feel very angry ... because I will never know whether, if I had taken Matthew to another hospital, he might be alive today."
It emerged during the hearing that other consultants at the Bristol Royal Infirmary received warning letters from the GMC although they were not charged.
Evidence given in defence of Mr Wisheart and Mr Dhasmana suggested that for some of the children there was inadequate diagnostic information available before the operations and poor post-operative care provided after them. In addition to the two surgeons, cardiologists, radiologists, anaesthetists and paediatricians were involved in the treatment of the children. Success in surgery depends on the whole clinical team and the inquiry will have to consider whether the two surgeons are carrying the blame for others' shortcomings.
An investigation by the BBC Panorama programme, to be shown tonight, says that the problems at Bristol were well known to other heart specialists for children from the early Eighties. Professor George Sutherland, a consultant cardiologist in Southampton, told the programme: "From the time I was appointed in 1983 there were, within the profession, some doubts about the quality of cardiac surgery being performed in Bristol and certainly worries about the mortality figures in young children. [The concerns were] that the unit wasn't performing in terms of operative skill and post-operative care as you might expect from a leading centre."
The programme interviewed Dr Norman Halliday, a retired Department of Health under-secretary, who had responsibility for overseeing Bristol and the other specialist children's units, and who knew of problems there in 1992, three years before official action was taken.
It also disclosed that a 1989 report commissioned by the health department showed that Bristol had the highest number of deaths of the nine national children's heart units and that concerns had been raised about its performance by other specialists since the mid-Eighties.
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