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The Bristol heart babies Sunday, 25 July, 1999, 12:35 GMT 13:35 UK
Lifting the shame of Bristol
Ash Pawade has brought stability and success to the hospital
Bristol Royal Infirmary is associated in the public's mind with the inquiry into children who died following heart surgery at the hospital. BBC News Online looks at the man who has taken on the job of turning its reputation around.

The heart of a new-born baby is an extraordinarily delicate device - about the same size as a small plum.

And so when a cruel arrangement of chromosomes makes it useless, it takes an equally extraordinary surgeon to arrange it into a working state.

The Bristol Heart Babies
For decades, surgeon James Wisheart epitomised those qualities, and many former patients, and their relatives, continue to hold him in the highest regard.

But the results of some his operations, and those of his colleague Janardan Dhasmana, left a severe blemish on Bristol Royal Infirmary.

Doctors' disciplinary body the General Medical Council (GMC) banned Wisheart from practising as a doctor, and Dhasmana from operating on children.

In 1995, on the other side of the world, preparing to take up a post in paediatric cardiac surgery at Bristol, was Ash Pawade.

But he had failed to appreciate precisely the scale of the problem he was to face.

However, in just under four years at the hospital, he has restored its reputation among the local population.

In demand

In fact, there is now more demand for child heart surgery at Bristol than there was before the scandal broke.

Pawade has just passed the milestone of his 1,000th operation since his arrival in 1995 - and his results remain well above the national average.

Bristol Royal Infirmary has been dogged by the scandal
He said: "I really did not realise how big a problem there was at Bristol. I knew there were problems, but at that time the publicity had not started.

"After I took up the post, people in Melbourne kept showing me press cuttings about Bristol. I did wonder what I had let myself in for."

What he had let himself in for was a service in crisis, still more than two years of poor publicity away from the GMC verdict.

Many of the obstacles to success at Bristol had little to do with the performance of the two departed surgeons who had been suspended pending the conclusion of the GMC inquiry.

No theatre for babies

Among the most serious was the fact that Bristol Children's Hospital, adjoining Bristol Royal Infirmary, had no dedicated operating theatre.

Babies needing heart surgery were transported into the main hospital building, and then into a standard intensive care unit rather than one designed and staffed with infants in mind.

Disgraced surgeon James Wisheart flanked by police
Ash Pawade says: "It was a complete mess, and thankfully a lot has happened since then to put it right."

A new operating theatre costing more than 1m was built at the children's hospital, and specialist staff in intensive care for new born babies were recruited.

This month saw the appointment of a second cardiac surgeon specialising in babies.

Pawade says morale is now extremely good in the unit, and he claims to have won the complete support of the region's doctors, as evidenced by the high number of children referred to him for surgery.

Winning back confidence

And even the confidence of local people seems to have been restored.

The hospital trust is the only one that publishes its paediatric cardiac results on its website in a determined effort to lay to rest the ghosts of the past, despite the constant reminders offered by proceedings in the public inquiry.

And the surgeon says he sees his foreseeable future in Bristol.

"I've led a fairly nomadic existence, born and raised in India, and working in Australia, but strangely, my links with England have always made me think of it as home.

"What I've helped achieve here has been the most satisfying experience of my life."

Ash Pawade talks about his experiences in the Radio Four programme "A Hard Act to Follow", to be broadcast on Thursday 29 July at 0900 BST.

See also:

15 Mar 99 | The Bristol heart babies
15 Mar 99 | The Bristol heart babies
15 Mar 99 | The Bristol heart babies
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