Surgeon expects to be exonerated in Bristol deaths

JAMES WISHEART, the consultant surgeon and former medical director of the Bristol Royal Infirmary, yesterday defended his role in the baby heart disaster and claimed that history would exonerate him.

Speaking less than 24 hours after sobbing parents gave their closing statements to the public inquiry - the biggest in the NHS's history - Mr Wisheart said he was a competent surgeon who had done his best.

He told the BBC Radio 4 Today programme: "I am a human being as well as a surgeon and I have never claimed to be perfect. But 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."

Asked if some of the babies would have lived if they had been treated elsewhere, he replied: "Nobody can say whether they would or would not."

His comments are partly supported and partly contradicted by evidence presented to the inquiry last month following a clinical notes review of 80 children who underwent 100 operations. They were a randomly selected sample of the 1,900 children who had complex heart surgery at the infirmary between 1984 and 1995, the period the inquiry is examining.

The review found that in half the cases the clinical care was inadequate and in a third it was poor. The experts who analysed the results concluded that Bristol's death rate was the highest, at 34 per cent above the average, for the 12 specialist children's heart centres, and that 170 of the 1,900 children - almost one in 10 - might have survived or had a better outcome if they had been operated on elsewhere.

However, the review pinned the blame for the failings on the entire surgical team and not only on the surgeons. It identified deficiencies at every stage of care through diagnosis, admission and preparation for surgery to post-operative and intensive care.

In nine operations out of the 100 the surgery was judged to have been below standard but in only two did the experts consider that a better surgeon would have had a different outcome.

Bristol parents point to his death rate for one procedure - AVSD or hole in the heart repairs - on which the General Medical Council investigation focused which led to his being struck off last year. Mr Wisheart carried out 15 operations over five years and nine of his patients died, a mortality rate of 60 per cent. Initially the operations went well and the first four patients survived but he then had a run of bad cases.

Defending his record yesterday, he said: "The fact is that these children, many of them, had, first of all, serious underlying conditions, and they nearly all had additional factors which made a successful outcome, if not impossible, very much less likely than would normally be expected."

The four member inquiry panel will not give its view on Mr Wisheart's record until it has sifted the evidence given by 140 witnesses over 95 days of hearings, which ended on Thursday. Phase two of the inquiry, beginning in January, will examine the wider implications for the NHS and the final report is expected in the autumn.

Two clear themes have already emerged - that the surgeons were not alone responsible for the disaster and that, when the first reports of problems with paediatric heart surgery began to filter out, they were ignored, dismissed or not acted on by those in charge at every level from the hospital board through the Royal College of Surgeons to the Department of Health. No one was prepared to accept ultimate responsibility.

One of the unacknowledged roles of the multi-million pound inquiry has been to aid the healing process for the scores of parents who have been unable to come to terms with the loss of their children. But as those who gave harrowing accounts of their suffering on the final day showed, there will be no easy cure for the grief of bereaved parents.