Intended for healthcare professionals


Bristol inquiry into baby deaths to move into new phase

BMJ 2000; 320 doi: (Published 01 January 2000) Cite this as: BMJ 2000;320:9
  1. Clare Dyer, legal correspondent
  1. BMJ

    The inquiry into children's heart surgery services at Bristol will move into a new phase in the new year, looking at the wider issues that the saga has thrown up for the health service as a whole, such as the determinants of performance and professional and managerial culture.

    Just before the inquiry adjourned for Christmas, the chairman, Professor Ian Kennedy, announced that his panel would produce a special report on the issue of retention of organs after postmortem examination, at the request of the chief medical officer for England, Professor Liam Donaldson.

    The revelation that for years doctors at Bristol Royal Infirmary and other British hospitals had been retaining children's organs without their parents' knowledge provoked a public outcry. The inquiry commissioned a legal opinion from Ian Dodds-Smith, a solicitor and expert on the law on medical research, which suggested that hospitals were within their rights to retain the organs.

    But the Bristol parents' group produced a conflicting opinion. Professor Kennedy said that there was a “pressing need for clarification of what is proper from both an ethical and legal perspective.”

    Before the adjournment the inquiry heard from James Wisheart, former medical director at Bristol Royal Infirmary and the senior of the two surgeons found guilty of serious professional misconduct by the General Medical Council last year for continuing to operate despite mounting concerns about high mortality.

    After three days of evidence Mr Wisheart spoke to the media for the first time since he was struck off the medical register by the GMC. He told reporters after finishing his evidence: “In a sense the problems experienced at Bristol are like a microcosm of the National Health Service— doctors, surgeons battling against difficult circumstances, with inadequate resources, and in a culture where the finding of scapegoats appears to be put before the finding of solutions.”

    Later, in an interview broadcast on BBC Radio 4's Today programme, he insisted that he would be vindicated in time, although he accepted that he should have consulted colleagues sooner and sought their advice rather than just relying on his own opinion.

    “I have done my best and I believe I have produced acceptable results and I believe that the record in time will be seen to show that.”

    He said that the children he operated on had serious underlying conditions and “nearly all had additional factors, which made a successful outcome very much less likely than would normally have been expected.”

    Asked if some of the children would be alive today if they had been operated on elsewhere, he said that was impossible to tell. When the reporter asked whether he would have let fellow surgeon Janardan Dhasmana, banned by the GMC from operating on children for three years, perform surgery on one of his own children, Mr Wisheart hesitated. He then said that he was not sure that the question was fair, but insisted he had great confidence in Mr Dhasmana as a surgeon.

    Earlier, he told the inquiry that he had stopped operating on children because of stress and anxiety from seeing so many of his patients die. Although he believed there were “true and proper” factors accounting for the deaths, the “anxiety and emotional investment or drain weighed very heavily.”

    The one thing he could clearly say he regretted was not consulting colleagues earlier over his disappointing results. But he was not sure this would have led him to stop sooner.

    Embedded Image

    Surgeon James Wisheart: “I believe I have produced acceptable results”

    (Credit: PA PHOTO)

    View Abstract