THE SECRETARY OF STATE FOR HEALTH'S ANNOUNCEMENT OF A PUBLIC INQUIRY INTO PAEDIATRIC CARDIAC SURGERY SERVICES AT BRISTOL ROYAL INFIRMARY
Frank Dobson, Secretary of State for Health, made the following statement to the House of Commons on Thursday 18 June 1998:
"I promised that once the General Medical Council had completed its disciplinary proceedings against the three doctors concerned, the Government would establish an independent inquiry into children's heart surgery at the Bristol Royal Infirmary. On 29 May, the GMC announced that it had concluded that many of the charges against the doctors were proved. It has taken further time to consider what action to take against the doctors concerned. Today, it has struck off two of them, Mr Wisheart and Dr Roylance, and censured Dr Dhasmana.
The inquiry will be chaired by Professor Ian Kennedy, professor of health law, ethics and policy at University College London. He is an eminent lawyer and an expert in medical, legal and ethical issues. He has written extensively on problems arising from the care of severely disabled new-born babies. He has chaired the Expert Advisory Group on ethics of xenotransplantation and the Advisory Group on rabies and quarantine. He was a member of the Expert Advisory Group on AIDS.
Under the National Health Service Act 1977, as Chairman of the Public Inquiry Professor Kennedy will have the power to require witnesses to attend the Inquiry; to give evidence on oath and to produce documents. Criminal penalties are available against any who refuse to do so.
I intend to announce the other members of the inquiry and its detailed terms of reference very soon. Today I can make it clear that the inquiry will examine all aspects of what went wrong at Bristol. It will identify any professional, management and organisational failures and make recommendations to safeguard patients and their families in the future.
I have had three meetings with the representatives of parents of children who died or suffered brain damage following heart surgery at Bristol Royal Infirmary. I was deeply impressed by their grief at what had happened to their children, by their dissatisfaction with how they - the parents - has been treated since, and by their disillusion with the clinical, professional and management arrangements which failed to deliver the standards of treatment and care that everyone has come to expect from the national health service. We owe it to them to get to the bottom of what went wrong in Bristol - that all the facts are exposed and responsibility is identified. We also owe it to them to try to complete the inquiry within a reasonable period so that they can make a new start in their lives. We owe it to them and everyone else in our country to make sure that lessons are learned so that such a tragedy never occurs again.
The Government are not going to wait for the outcome of the inquiry before taking action to in place new machinery for setting and maintaining clinical standards in the national service. As we spelled out in December in our White Paper, "The New NHS", we are introducing a whole range of measures.
We will establish a national institute for clinical excellence to set national standards. No such organisation exists at present. We will place a duty of clinical governance on NHS trusts. They do not have such a duty at present. To make sure that the new national standards are being met, we will establish a commission for health improvement. There is no such organisation at present. We will require all hospital doctors to participate in national external audit. There is no such requirement at present.
We will enable all patients and their GPs to get information on treatment success rates at their local hospital. They have no such right at the moment. All those measures have been welcomed by the Bristol parents. They have been welcomed by the medical nursing and midwifery professions. They will be included in our forthcoming national health service Bill. Where legally possible, we will proceed with some changes even before the Bill becomes law.
As I said when I met them last Friday to the representatives of the Bristol parents, the measures already in train and any further changes which result from the public inquiry will be too late to save their children; but I think I was speaking on behalf of us all when I expressed to the parents my hope that they would gain at least some consolation from the knowledge that the lessons learned from what their children has suffered should mean that nothing like it ever happens again."
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