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The Bristol heart babies Monday, 15 March, 1999, 23:32 GMT
Bristol babies timeline
Three doctors at the centre of the biggest-ever medical disciplinary inquiry were found guilty of serious professional misconduct in June 1998.

Twenty-nine babies and toddlers died after complex heart surgery at Bristol Royal infirmary.

The Bristol Heart Babies
An independent public inquiry is to investigating how the tragedy was able to happen.

This is the sequence of events that led to the public inquiry:

1975: Heart surgeon Mr James Wisheart joins Avon Area Health Authority, later to become the United Bristol Healthcare NHS Trust.

1986: Mr Janardan Dhasmana is appointed heart surgeon at Bristol Royal Infirmary, one of nine centres in the UK specialising in children's heart surgery.

Stephen Bolsin blew the whistle
1988-1995: Mr Dhasmana carries out 38 arterial switch operations - and 20 of the young patients die.

1988: Dr Stephen Bolsin, a consultant anaesthetist, joins Bristol Royal Infirmary. He notices that children's heart operations last up to three times as long as in other hospitals, and that youngsters are dying from relatively routine operations.

1990-1994: Mr Wisheart performs 15 atrio-ventricular septal defect (ASVD) operations. A total of nine of the young patients die.

1991: Dr John Roylance is appointed chief executive of the United Bristol Healthcare NHS Trust.

1992: Mr Wisheart is appointed medical director of the hospital.

Jessica Gibbons died after a heart operation
1995: Mr Wisheart stops operating on children and concentrates on adult heart surgery.

1995: Dr Roylance retires.

1996: Parents write to the General Medical Council (GMC), the doctors' regulatory body, asking for an investigation into the professional conduct of Mr Wisheart, Mr Dhasmana, and Dr Roylance.

1996: Mr Wisheart suspends all his surgery and steps down as medical director.

1997: Mr Wisheart retires.

1997: Independent review is published.

1997: The then Health Secretary, Stephen Dorrell, orders an inquiry into the heart surgery service at Bristol Royal Infirmary.

1998: In June, the GMC finds Mr Wisheart, Dr Roylance and Mr Dhasmana guilty of serious professional misconduct.

Mr Wisheart and Dr Roylance are struck off - banned from practising medicine.

Mr Dhasmana is banned from operating on children for three years.

Dr Roylance decides to appeal against the GMC ruling.

The GMC issues new guidelines telling doctors how and when should report a colleague whose performance they thought was putting patient safety at risk.

Health Secretary Frank Dobson greets with fury the GMC decision not to strike off Mr Dhasmana.

He announces an independent public inquiry to be chaired by medical law and ethics specialist Professor Ian Kennedy.

The Department of Health announces raft of measures to ensure high standards in the NHS.

These include:

  • the use of the proposed National Institute for Clinical Excellence to set guidelines for best practice
  • the proposed Commission for Health Improvement which will ensure that practitioners meet the standards the institute sets
  • government plans to give patients a say in doctors' merit awards - payments that mean can double a consultant's earnings. These come after it emerges that Mr Wisheart receives an A merit award worth 50,000 a year
  • government plans to publish league tables of the death rates at hospitals.

Mr Dhasmana is sacked by Bristol Royal Infirmary, but decides to appeal, backed by a group of former patients and relatives.

A week before the inquiry is due to start preliminary hearings at the end of October, the Senate of Surgery issues proposals to ensure doctors monitor their own performance and are not allowed to carry out procedures that are beyond their competence.

It also proposes "rapid response teams" of specialists to take over surgery at hospitals where death rates are unacceptably high.

Under the proposals, consultants will have to undergo regular appraisals to establish that they are still fit to practice.

1999: As the start of full public inquiry hearings approaches, the scandal is still having an impact.

In February, doctors at the GMC vote that they should be demoted or even struck off if they do not pass regular MOTs on their skills.

Dr John Roylance appeals to the Privy Council to have the GMCs decision to strike him off the medical register overturned.

Meanwhile, parents groups are angered as it emerges that the hospital retained dead babies' organs.

The hospital says it is standard practice to remove organs for post-mortems and consent is not a legal requirement, but Mr Dobson says this is disturbing and the inquiry must look into the issue.

On the eve of full hearings at the public inquiry, Mr Dhasmana - who lost the appeal against his sacking - says he plans to take his former employers before an industrial tribunal.

March 16: The public inquiry starts in Bristol.

BBC News
BBC Radio 5Live's Sharon Alcock explains the background to the GMC case
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