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The Bristol heart babies Monday, 15 March, 1999, 23:37 GMT
Uncovering the Bristol scandal
18.46 15-03-99 Matthew Hill
BBC West of England Health Correspondent Matthew Hill brought the scandal of paediatric heart surgery at Bristol Royal Infirmary to the attention of a wider audience. As the public inquiry into those shocking events gets under way, he examines the history of the case.

Consider the following statement from Professor Ian Kennedy, who will chair the inquiry.

The Bristol Heart Babies
"Nothing less than an examination of the state of affairs which could lead to such tragedy in Bristol, indeed an examination of the very culture in which health care in the NHS operated in the relevant period.

"From this examination, we must then distil recommendations which will aim to see to it that there is never another Bristol, nor anything like it."

Worthy sentiments, but will this investigation, which could last up to two years, really ensure such a tragedy is not repeated?

The inquiry has been set up to find out why death and serious injury went on year after year.

But this is also an opportunity for a thorough examination of the very culture in which health care in the NHS operated during the period in question - and whether lessons can be learnt.

Meeting a concerned doctor

It was shortly after arriving in my post exactly four years ago that I heard a young anaesthetist at the BRI was unhappy with mortality rates for paediatric cardiac surgery.

19.19 15-03-99 bolsin ac
Dr Stephen Bolsin: Concerned
Rumours about the standards of treatment had appeared in the satirical magazine Private Eye in 1992 - they had been sent in anonymously - but until then none of the mainstream media had touched the story.

I visited Dr Stephen Bolsin's home one evening, and found the atmosphere understandably very tense.

He told me that five years earlier in 1990 he had written to the then head of the district health authority, later to be BRI chief executive, to raise his concerns about what seemed to be a higher than average death rate for newly born babies.

19.19 15-03-99 wisheart ac
Mr James Wisheart: Struck off
His allegations against the head of his cardiac unit James Wisheart were dismissed and Dr Bolsin claims the surgeon then threatened to ruin his career prospects should he pursue the matter.

He was left with little choice but to carry out his own audit of results. Fortunately, he was in charge of audit for the Royal Society of Anaesthetists.

He soon confirmed that, for one particular hole in the heart procedure, nine out of 12 of Mr Wisheart's patients had died - a figure far higher than the national average.

19.19 15-03-99 dhasmana ac
Mr Janardan Dhasmana: Sacked
He was also very concerned about the other surgeon Janardan Dhasmana's record for a complex operation known as "the switch".

Over the period in question he carried out 38 operations with 20 deaths.

Dr Bolsin became quite distressed when he told me how the last switch had taken place only two months before in January 1995 on Joshua Loveday from Gloucester.

The night before his death an extraordinary meeting of the cardiac team took place. Every doctor, except Dr Bolsin, agreed it should go ahead.

But concerns about the whole switch programme had spread outside the hospital because Dr Bolsin had contacted a key official from the Department of Health.

Department of Health intervention

That evening Dr John Roylance, by then chief executive of BRI, had a phone call at home from the official, Dr Peter Doyle.

19.19 15-03-99 roylance ac
Dr John Roylance: Struck off
Dr Doyle expressed worries about the operation going ahead. The former chief executive said although he was a doctor, he could not intervene over the clinical judgement of the doctors directly involved.

Meanwhile, Joshua's parents knew nothing about the debate. Joshua died the next day during the operation. Joshua's death was the catalyst that made Dr Bolsin risk his career by talking to me.

I then met the chairman of the hospital and told him I had enough information to break the story and I could do it with or without their co-operation.

To my amazement they handed over a report into the crisis carried out by one of the country's leading heart surgeons, Mr Marc De Leval of Great Ormond Street.

Scandal resulted in bans for doctors

This gave me the ammunition to expose the scandal in a piece on the Close Up West regional news magazine programme in April 1995.

Three years later Mr Wisheart and Dr Roylance were banned from practising medicine following the longest disciplinary hearing in the history of the General Medical Council.

Mr Dhasmana was also found guilty of serious professional misconduct. Although he was not struck off his position became untenable and he was later sacked.

Dr Roylance has appealed to the Privy Council to have the GMC's decision reversed, while Mr Dhasmana is taking his former employers to an industrial tribunal.

Matthew Hill reports on the series of failed child heart operations
Richard Hannaford reports: "Re-validation for doctors"
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