Far more than two bad apples

The Bristol Baby scandal goes far deeper than we might realise

Three years after the Bristol babies heart surgery disaster started to unfold, shocking facts continue to emerge. The latest expert assessment, released by the public inquiry last Thursday, suggests that 90 dead and damaged babies might have been saved with better care, and that 540 others received care that was "less than adequate" between 1984 and 1995. Now we understand why the paediatric cardiac unit at the Bristol Royal Infirmary was dubbed "the killing fields".

Three years after the Bristol babies heart surgery disaster started to unfold, shocking facts continue to emerge. The latest expert assessment, released by the public inquiry last Thursday, suggests that 90 dead and damaged babies might have been saved with better care, and that 540 others received care that was "less than adequate" between 1984 and 1995. Now we understand why the paediatric cardiac unit at the Bristol Royal Infirmary was dubbed "the killing fields".

But while we know, broadly, what happened in Bristol, the mystery is how it happened - how a hospital committed to saving babies ended up burying them. And went on burying them, year after heart- breaking year.

Tonight Channel 4 broadcasts a two-hour "factual drama" that attempts to get at the truth of the catastrophe. Based on the public inquiry evidence, it is meticulously faithful to the events it reconstructs.

The outline facts are well known. Through the 1980s and early 1990s, the surgeons James Wisheart and Janardan Dhasmana continued to perform heart surgery on new-born babies and infants despite repeated warnings about poor survival rates. Along with the hospital's chief executive, John Roylance, they were later found guilty of serious professional misconduct by the General Medical Council.

Given the subject, it would have been easy for the directro, Peter Kosminsky, to produce a Hollywood-style tear- jerker. But the film tries to capture the complexity of both personalities and events. For if there is one thing the Bristol disaster is not about it's two bad surgeons turning a hospital rotten. That would make it easy to dismiss as a "local failure", the words used by the former president of the Royal College of Surgeons, Sir Rodney Sweetnam, the day after the GMC verdict was handed down in June 1998.

The surgeons, Wisheart and Dhasmana, are the only names associated with the scandal but they were far from being the only ones responsible for it. The film lays bare the "institutional arrogance", highlighted by the public inquiry's interim report into the organ retention scandal, that lay behind the surgeons' failure.

As the death toll mounts, we see the bickering and petty rivalry among the consultants - anaesthetists and cardiologists, as well as the surgeons - and a loss of confidence among the nurses. Above all, there is a fatal complicity by all involved to "keep the train moving" even though passengers were falling off, as the whistleblower, the consultant anaesthetist Stephen Bolsin, later put it to the public inquiry.

The film, which focuses on four families, closes with a list of 174 children who died after heart surgery at Bristol Royal Infirmary, some of whom would have survived with better treatment.

It is the final throat-tightening moment. One of the strongest complaints of the Bristol parents is that the GMC case focused on only 29 babies who died or were brain-damaged. Naming others who lost their lives was important to the parents. This film properly honours their memory.

* 'Innocents' is shown tonight at 9pm on Channel 4. Jeremy Laurence is health editor.