Heart babies inquiry faces bias charge

A PUBLIC inquiry into an NHS hospital that was the scene of one of the worst medical disasters of recent decades opened in Bristol yesterday amid accusations that it was biased before it had begun.

Professor Ian Kennedy, the chairman of the Bristol Royal Infirmary Inquiry into the deaths of babies following heart surgery, said its aim would be to examine what led to the tragedy so that lessons could be learned for the rest of the NHS. "From this examination we ... will aim to see to it that there is never another Bristol nor anything like it."

This brought an angry response from supporters of the three doctors found guilty of serious professional misconduct by the General Medical Council (GMC) last June. Martin Berry, the acting chairman of the Bristol Surgeons Support Group, representing 600 grateful patients of the doctors, said that the three had already been victims of one miscarriage of justice before the GMC and feared they would now be victims of another. "I think the inquiry has prejudged the issues before it has heard any evidence. It is already loaded against the surgeons," Mr Berry said.

However, Professor Kennedy firmly rebutted charges of bias and pledged the inquiry would seek to discover the truth of what happened rather than apportion blame. Answering one questioner, he said: "In the views of many, what transpired at Bristol was a tragedy for some. In those circumstances it is appropriate to find a way forward."

The eight-month GMC hearing examining the deaths of 29 babies and children, the longest and one of the most emotive hearings in its history, concluded that the surgeons James Wisheart and Janardan Dhasmana had continued to operate, despite their poor success rate, long after they should have stopped and that John Roylance, the former chief executive of the infirmary, failed to intervene to prevent them.

The GMC, the doctors' disciplinary body, operates like a criminal court and could not consider the wider issues raised by the case; these have been left to the public inquiry, which was promised by Frank Dobson, the Secretary of State for Health, last year.

Giving his opening statement in the Bristol City Council House, Professor Kennedy said the cases of every child who underwent complex heart surgery at the infirmary between 1984 and 1995 would be considered; the Bristol Surgeons Support Group claims that there more than 1,000 such cases. Professor Kennedy said the inquiry would not attempt to judge the standard of care in every case but would seek out the lessons from the way the heart surgery service was organised at Bristol. The inquiry is not expected to report until well into the year 2000.

The inquiry is also expected to look at the role of other staff in the hospital, including nurses and consultants, who continued to refer patients for heart surgery and assist with operations, despite knowing of the high death rate. Professor Kennedy said the aim would be to examine "the very culture in which healthcare operated in the NHS". He said he wanted the inquiry to be as open, inclusive and accessible as possible and invited anyone with a story to tell or evidence to present to make contact. A freephone number and an e-mail address have been set up and when hearings begin next spring, in Bristol and London, video links will be established and the transcript of each day's hearings will be published on the Internet.

Yesterday's opening day, held to explain the procedure and hear applications for legal aid from potential witnesses, was dominated by supporters of the surgeons wearing white T-shirts emblazoned with red lettering. It was in sharp contrast to the scene at the GMC in the summer when the rival Bristol Heart Children Action Group, representing 250 families whose children died or were brain-damaged following heart operations at the hospital, laid a row of miniature coffins on the pavement outside the council's London HQ.

Malcolm Curnow, a spokesman for the action group, said they wanted the inquiry to get on with its job unhindered. "We have campaigned long and hard for a public inquiry. It is the last chance for the parents to get at the truth."

The existence of the two opposing camps and the extreme sensitivity of the issues highlights the difficulty Professor Kennedy faces in steering a course between them and preventing the inquiry become a show trial. Many times yesterday, he stressed that his aim was to discover the truth, not to take sides. It is clear that not all those involved see it that way.