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The Bristol heart babies Monday, 19 July, 1999, 17:22 GMT 18:22 UK
Surgeon tells of 'chronic workload'
operating theatre
Heart operations at Bristol are under the spotlight
The surgeon at the centre of the Bristol babies heart affair has told a public inquiry of the long hours he and colleagues worked in "intolerable conditions".

Former Clinical Director James Wisheart is facing two days of intensive questioning in front of some of the parents of children who died following surgery at the Bristol Royal Infirmary.

The Bristol Heart Babies
His evidence came on the day it was revealed that the hospital at the heart of the scandal is set to pay out a huge sum of money to a child left brain damaged following an operation carried out by Mr Wisheart.

Ian Stewart, whose parents Jim and Bronwen carried out a half-hour protest at the hearing, describing the inquiry as a "cover-up", is confined to a wheelchair.

The United Bristol Healthcare Trust admitted that it failed to give accurate information to Ian's parents about the risk of brain damage.

Long hours and 'intolerable' conditions

Mr Wisheart told the hearing that huge demands for heart surgery, both child and adult, in the late 1980s meant the entire cardiac team, with just three surgeons, often worked long hours, day and night.

The annual number of operations increased from 250 to 750 in just five years, he said.

He said the "chronic workload" led them to write a memo to senior managers describing working conditions as "intolerable", and asking for another surgeon to be appointed.

However, when the new surgeon arrived, the hospital trust management demanded that more operations be carried - increasing the workload again.

Attempts to recruit a dedicated paediatric heart surgeon had been unsuccessful, he said, and he confirmed there were problems recruiting other specialists in child heart problems.

In addition, the surgeon agreed that the arrangement of the hospitals, which meant that children had to be taken from the children's hospital to Bristol Royal Infirmary for surgery, could have affected the quality of the service.

Before the hearing, Mr Wisheart issued a statement expressing a hope that a "balanced view" of events would be reached.

'Serious misconduct'

Mr Wisheart, who is now retired, was struck off by the doctors' regulatory body, the General Medical Council (GMC), last year.

It found him guilty of serious professional misconduct, for continuing to operate on infants with serious heart abnormalities - despite his death rate being unacceptably high.

Ian Stewart, who underwent a heart operation at four months old, has been offered 100,000 by the trust, but a judge may eventually award far more.

The NHS Litigation Authority, which handles damages claims against the health service, is now dealing with 193 actual or potential cases involving Mr Wisheart or his former colleague, Mr Dhasmana.

Some 29 cases have already been settled for sums believed to be in excess of 550,000.
James Wisheart
James Wisheart faces two days of intensive questioning.
Between 1990 and 1994, Mr Wisheart carried out 15 operations on atrio-ventricular septal defects - many are more commonly termed "hole in the heart" operations.

Nine of the 15 died either during or shortly after surgery at the infirmary.

Mr Wisheart had told the GMC that the poor results had been due to a "cluster" of difficult cases.

Following the case, in which former the infirmary's Chief Executive, Dr John Roylance, was also struck off and surgeon Janardan Dhasmana was banned from operating on children, the Health Secretary, Frank Dobson, ordered the public inquiry into paediatric cardiac surgery at the hospital.

It hopes to discover whether the deaths were avoidable, and if not, whether they were due to human error, management failings or a combination of these and other factors.

The BBC's Matthew Hill: "The Bristol surgeons worked long hours"
The BBC's Keith Breene: "The practice of keeping organs without consent has been commonplace for years."
Mathew Hill reports: "It's now a year since James Wisheart was struck off"
See also:

11 Feb 99 | The Bristol heart babies
22 Mar 99 | The Bristol heart babies
07 Jun 99 | The Bristol heart babies
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