Families await Bristol babies report

The long-awaited report of the inquiry into the Bristol heart babies scandal is published on Wednesday.

Doctors are bracing themselves for damning conclusions about what went wrong at the heart unit of the Bristol Royal Infirmary - conclusions that could have a profound impact on the future of the NHS.

It is thought that the report will be highly critical of the whole regime at Bristol, and may question whether child heart surgery should have been carried out at the unit at all.

Health Secretary Alan Milburn will respond to the findings in a statement in the House of Commons on Wednesday afternoon.

James Wisheart was struck off

Helen Rickard's daughter Samantha died after undergoing surgery at Bristol. Her husband, Andy subsequently committed suicide.

She hopes the inquiry will lead to sweeping reforms so that nobody else has to suffer similar pain.

She said: "There are no words to describe what it is likely to live through something like that. The agony is unspeakable.

"It is with me every day. That is why it is so important that a loss like that is turned into something positive for everybody."

Trevor Jones, of the Bristol Heart Children's Action Group, lost his daughter Bethany at Bristol.

He said: "We hope that our daughter did not die in vain and that the medical profession learns from the mistakes of Bristol."

Child deaths

The report will say that up to 150 children died at the BRI after undergoing 13 different types of operation between 1984 and 1995.

Many would probably have died anyway, but for five of the seven years between 1988 and 1994 Bristol recorded death rates significantly higher than those at other heart units.

Between 1991 and 1995 there were up to 35 deaths more than could reasonably have been expected.

This was either due to failings associated with the surgery, or to poor follow-up intensive care.

The report is also expected to expose serious flaws in monitoring and regulating the work of doctors, not only at Bristol, but across the whole NHS.

And it is likely to call for much greater openness, with patients being given information on surgery survival rates.

It is also expected to condemn the culture of "institutional arrogance" in medicine, and the "tribalism" of doctors.

Unit closures

There has also been speculation that the report will recommend the closure of more than half of Britain's child heart surgery centres because of evidence that staff are not doing enough operations to maintain their skills.

My earnest hope is that the report will lead to a genuine commitment on the part of the medical profession to implement policies to enable the monitoring of professional practice in all specialties

Dr Stephen Bolsin

The inquiry team, led by Professor Ian Kennedy, has spent three years investigating why botched operations at the hospital were allowed to continue for 11 years.

Following a General Medical Council (GMC) investigation, which concluded in 1998, heart surgeon James Wisheart was struck off the medical register.

His colleague Janardan Dhasmana was banned from operating on children for a total of four years.

Both were found guilty of serious professional misconduct after they continued to operate on children despite poor survival rates.

Covering up

The hospital's chief executive John Roylance was also struck off for covering up the surgeons' inadequacies.

Helen Rickard lost her daughter and husband

The GMC looked at 53 cases involving two types of heart surgery carried out between 1988 and 1995. It concluded that 29 children died after being operated on by Wisheart and Dhasmana.

However, some families of children treated at the hospital have remained fiercely loyal to the disgraced surgeons in the case, claiming they have been used as scapegoats for underfunding and a wider malaise within the system.

The problems at Bristol were exposed by Dr Stephen Bolsin, who worked as a relatively junior consultant anaesthetist at the hospital.

He has since returned to his native Australia, complaining that he was subjected to threats and intimidation when he tried to alert the authorities to what was going on.

Speaking this week, Dr Bolsin said: "My earnest hope is that the Bristol Royal Infirmary Inquiry Report will lead to a genuine commitment on the part of the medical profession in the United Kingdom to implement policies to enable the monitoring of professional practice in all specialties.

"Such policies and procedures should be capable of identifying excellence, endorsing acceptable practice and raising the standards of medical practice, before any patient harm occurs."

Bristol has already led to major changes in the way medicine in the UK is regulated, including the creation of a new inspection authority, and the introduction of a system of appraisal for doctors.