Annex A > Chapter 18 - Medical and Clinical Audit > The audit and review of the paediatric cardiac surgical services in Bristol > Evening meetings
<< previous | next >>
Evening meetings
437 The Inquiry heard evidence about informal evening meetings held at the homes of consultants, from the early to mid-1980s. [523]
438 Mr Wisheart described these as `multi-disciplinary evening meetings' and explained that they `were attended by cardiologists, surgeons, anaesthetists, radiologists and pathologists' and took place two to four times a year. [524] Mr Dhasmana referred to these meetings as meetings of the `paediatric club'. [525]
439 Mr Wisheart stated that the agenda of these meetings:
`... was not limited to audit, but it did include review of the annual statistical summaries and occasional series of patients, particularly before other more formal audit activities began in 1990-1991. The clinical series reviewed included Fallot's tetralogy repair in 1991, VSD closure in 1988 or 89 and the prevention and management of pulmonary hypertension. Thus the emphases was on a series of patients, rather than the individual patients.' [526]
440 Mr Dhasmana stated that at the meetings:
`... some important issues in the management of postoperative problems were discussed and recommendations implemented. For example an important guideline was formulated for the management of postoperative pulmonary hypertension in patients with complete AV canal and in some cases of Tetralogy of Fallot following this [a] meeting in 1989/90. The issue of Arterial Switch in older children was reviewed in one such meeting in December 1994. Similarly Dr Hayes chose to discuss the topic of Protocol and Review of correct practice in paediatric cardiology in one of these meetings in June 1994.' [527]
441 Dr Masey stated that the meetings:
`... would quite often be chaired by the person in whose home the meeting was being held ... I felt it was a very good opportunity to talk to people because the environment was moderately informal, and ... there were also meetings where more people were usually able to attend because they were out of the normal working day.' [528]
442 Dr Bolsin believed he was `obstructed' in carrying out audit of paediatric cases. He expanded on that in the following exchange:
`A. I think that there was another incident when I produced minutes of one of the informal evening audit meetings and I was told that they were not acceptable outside of the meeting. So that not at the time, when the minutes were being considered to be accepted at the meeting, before the next meeting was arranged I was told: "these minutes will not be circulated, this is not how we do things, I do not want you keeping minutes again". That to me could be construed as obstruction. I probably brought that in as "obstruction" in my statement.
`Q. We have been told by Mrs Masey [sic] that it was her who said that to you, and we have been told by Mr Wisheart and from comments he has made that he did not say that to you. Are they right or are they wrong?
`A. I think Dr Masey is right, she did say it. Mr Wisheart may be wrong. I believe he also said that to me as well.
`What surprised me was that here was a concerted attempt by two members of the meeting, not to correct the minutes when they are presented at the next meeting, which is the usual way things are done, but actually to say "You are not to circulate these or keep minutes again".' [529]
443 Dr Joffe told the Inquiry:
`We had a very small, close-knit group of five or six people and I think our thorough airing of the situation with a conclusion that we had come to at the end of it was sufficient for all of us to then take on whatever policy changes we had decided upon, and all of us would stick to them. So there was no problem in not having minutes for that kind of discussion.' [530]
444 Mr Dhasmana explained that: `Since it was an informal meeting, records were not kept regularly, ...'. [531] Dr Jordan stated: `... these meetings were not minuted.' [532]
445 Dr Joffe stated that the discussions at these meetings were mainly focused on issues related to paediatric cardiology and surgery. He stated that anaesthetists did not come to every meeting, `But there were some issues that some anaesthetists did attend to discuss where their presence was certainly very important.' [533]
<< previous | next >> | back to top
Footnotes
[523] WIT 0120 0396 Mr Wisheart
[524] WIT 0120 0396 Mr Wisheart
[525] WIT 0084 0023 Mr Dhasmana. Although Mr Dhasmana referred to these meetings by a different name, he described them as taking place three to four times a year at the home of one of the consultants (in rotation)
[526] WIT 0120 0396 Mr Wisheart
[527] WIT 0084 0023 Mr Dhasmana
[531] WIT 0084 0023 Mr Dhasmana
[532] WIT 0099 0019 Dr Jordan