Annex A > Chapter 20 - Concerns: Foreword, 1984 and 1985 > Concerns

Concerns

Foreword

1 The next 11 chapters set out, in chronological order, the development of concerns about the paediatric cardiac surgical services at the United Bristol Hospitals and the UBHT (UBH/T). There is a distinction between a view that the service at the Bristol Royal Infirmary/Bristol Royal Hospital for Sick Children (BRI/BRHSC) was capable of improvement but was nevertheless acceptable, and a view that the service (or aspects of it) at the BRI/BRHSC was unacceptably poor. The expression of the latter view is that which the Inquiry regards as a `concern'. [1]

2 The following chapters, arranged annually, thus concentrate upon comments from various sources that the service was unacceptably poor. However, there is also evidence which led some individuals to identify what they saw as shortcomings in the Bristol service, and evidence from which it might be argued that others should have done so. This evidence, to an extent, is also reviewed in the chapters that follow. In particular, the Inquiry is conscious that the identification of a number of minor shortcomings might, when taken together, equate to an expression of concern. It is not the function, however, of this account of the evidence put before the Inquiry to pass any judgment upon these matters. It merely lays out the relevant evidence. Furthermore, at the end of each chapter will be found the available data (if any) for the year which the paediatric cardiac surgery Unit produced for its return to the UK Cardiac Surgical Register (UKCSR). Mr Wisheart said that he had maintained records of each and every operation he did (as did Mr Dhasmana), and that one of the purposes of doing so was to allow for a continuing review of performance.

3 It should also be noted that concerns expressed were not only in relation to Neonatal and Infant Cardiac Surgery (NICS). This was only part of the paediatric cardiac surgery work carried out at the BRI.

4 Finally, it should not be assumed that because events set out in the following chapters were simultaneous, or occurred in sequence, that any one individual was aware of that which was occurring, or being said, outside his or her direct personal involvement.

5 In order to provide an overview of the events which happened in any one year, there is a chronology in Chapter 31 - Chronology of Key Events Relevant to and Including Expression of Concerns. Like all chronologies, it aims to assist by simplifying, and should not be taken as a substitute for the evidence, but merely a précis of some of the main features of it.

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Footnotes

[1] In addressing this issue, the Inquiry bears in mind the distinction between expressing the opinion that the service at the BRI/BRHSC was capable of improvement but nevertheless acceptable; and the view that the service at the BRI/BRHSC (or aspects of it) was unacceptably poor. It is the latter which is meant by `an expression of concern'. See Issue N Inquiry on the Inquiry's Issues List in AnnexB