Annex A > Chapter 27 - Concerns 1992 > Concerns > Further concerns expressed at Bristol
<< previous | next >>
Further concerns expressed at Bristol
19 Professor Prys-Roberts met Dr Roylance on 14 February and 5 March 1992. Professor Prys-Roberts stated that on one of these occasions (probably the second), [22] he told Dr Roylance:
`... that Dr Bolsin had been collecting data, and that in my opinion he (Dr Bolsin) was correct to express concern about the results of cardiac surgery in babies. I did not have the data with me but I told Dr Roylance that Dr Bolsin would be prepared to show them to him. Dr Roylance said that I should leave the matter with him and that he would deal with it. I had every reason to anticipate that Dr Roylance would investigate the matter more fully, and deal with it.' [23]
20 Professor Prys-Roberts was asked about the meeting with Dr Roylance in the following exchange:
`Q. If we turn back then to the point at which you spoke to Dr Roylance, can I ask you firstly: the meeting took place after you had already had a meeting, with others, with Dr Roylance either on the subject of the relocation of the University department or on the subject of special increments for teaching and research. We have had two dates, 14th February and 5th March and I think both you and Dr Roylance agree that of those two dates the latter is the more probable?
`A. I think the latter is the more probable, yes ...
`Q. On the occasion you did speak to Dr Roylance, what did you say to him?
`A. I believe I used the term "I am concerned about the way Steve Bolsin is trying to make the information known within the Trust and within the hospital that the paediatric cardiac mortality is higher than it should be. I am aware that you have prior knowledge of this and I am simply expressing a concern that I have seen data that Steve Bolsin has presented to me, I do not have the data with me, but Steve has told me that he would have been willing to show you, Dr Roylance, the data" and I believe I used the term which I tend to use as a sort of throwaway phrase, "this is not something that we should sweep under the carpet".
`Q. Dr Roylance for his part says that that is a phrase that he would have found offensive.
`Q. What was his reaction to the phrase if you used it to him?
`A. I do not recollect him appearing to be offended or appearing to be disturbed by what I said. He was a fairly taciturn person and he simply said to me "I note your concerns and I will deal with them".
`Q. What was the general tone of the conversation, then?
`Q. Does the fact that Dr Roylance would find the use of such a term, he says, offensive but that the conversation apparently remained friendly not lead you to reflect a little on whether or not you in fact did use that term?
`A. I cannot be certain that I would use the term, but I think I did use the term.
`Q. Can you be confident that you would have mentioned figures or data to Dr Roylance?
`A. No, I would certainly not have mentioned specific numbers to him. What I said to him is I had seen a collection of data which seemed to me to support Dr Bolsin's contention that "there is a higher mortality than we should be happy to have in the BRI cardiac unit and I feel that you as the Chief Executive should know about it and maybe deal with it".
`Q. What was Dr Roylance's reaction to the suggestion that he should deal with data or figures on higher mortality?
`A. My recollection was that he said "yes" he would deal with it and I did not pursue as to how he would deal with it. I knew John Roylance very well as an individual and I expected him to do that.
`Q. Did he not seek to explore with you exactly what sort of figures had been collected?
`A. Not in detail because I had said that Steve Bolsin had the data; that he would be perfectly happy to share the data with Dr Roylance. One of the problems was that this meeting was relatively brief because Dr Roylance had another meeting to go on to but he had agreed to see me briefly after the end of the other meeting we had. This was an opportunistic way of talking to him about this concern of Steve Bolsin's.
`Q. Again Dr Roylance's suggestion is that if anyone had suggested to him that there was data or figures that had been gathered on performance of the unit, that he would have regarded that as being a matter for the Trust Audit Committee or Dr Thomas and that he would want to pass that on as a "political hot potato" as rapidly as possible. Was there no discussion of such a course of action?
`A. I have no recollection of any discussion of that nature at all.
`A. Because it was Dr Bolsin who had asked me to present the concern to Dr Roylance.
`Q. Here Dr Bolsin had been rebuffed, you understood, in the past. Why bring his name to the attention of the person who at least (presumably) played some part, you might have thought, in that previous incident?
`A. I am not sure I knew what John Roylance's part in the previous rebuff had been. I believe (again this is simply my own personal opinion) that Bolsin had written to the Trust, Roylance had dealt with it and passed the information back to Mr Wisheart who had then spoken to Dr Bolsin; I was not part of that process at all, so I cannot give you any more detail than that. But I was not under the impression that it was Dr Roylance who had rebuffed Dr Bolsin in the first place.
`Q. Was there any discussion that you can recollect, then, of the appointment of a paediatric cardiac surgeon and the need for that?
`A. There had been a lot of discussion in that sort of period during 1991. I was not involved in it. There were discussions about appointing a Professor ...
`Q. I was asking you specifically for your evidence in relation to the meeting with Dr Roylance, whether you recollect that subject being raised at that time?
`A. I do not recollect saying on that occasion that I was disappointed, but I may well have done, I simply do not recollect that.
`Q. Because you will appreciate that Dr Roylance's recollection is of a conversation about the need, indeed the urgency, of appointing a paediatric cardiac surgeon. Is it possible that the two of you did discuss that and that the explanation for this lack of agreement as to what took place was that both of you assumed it was necessary that that appointment should be made but from different perceptions of the reason why it was important?
`A. I would certainly agree with that last statement, but I do not recollect discussing that particular problem with John Roylance on that occasion because that was not my prime purpose in asking to see him after the other meeting. My prime purpose was to draw his attention to the fact that Steve Bolsin now had a set of data which I considered ought to be causing concern.' [24]
21 Dr Roylance was also asked about the meeting with Professor Prys-Roberts early in 1992 in the following exchange:
`Q. Do you recall Professor Prys-Roberts saying anything to you about data or figures that Dr Bolsin was collecting?
`Q. If Professor Prys-Roberts had been approached by Dr Bolsin and shown data, figures in respect of outcomes of paediatric surgery and you and he, that is you and Professor Prys-Roberts were discussing paediatric cardiac surgery, would you expect, given what you know of Professor Prys-Roberts, that he would have told you something about that?
`A. Yes, I would not describe Prys-Roberts and his relationship with me as reticent.' [25]
`... if he said to me that Dr Bolsin had data about cardiac surgery, it is quite inconceivable that I would not have immediately referred the matter to James Wisheart and talked to him about it and I did not because I was not given that information.' [26]
23 Also, in the spring of 1992, Dr Bolsin went to see Kathleen Orchard, General Manager of the Directorate of Surgery at UBHT. [27]
24 In her written evidence to the Inquiry Ms Orchard stated that:
`Dr Bolsin told me he was concerned about some of the work being performed in the cardiac unit. I do not recall him making specific reference to paediatric cardiac surgery, nor to any particular surgical procedure. I recall that he was making comparisons between the performance for some procedures in the Bristol unit compared with other United Kingdom units. He indicated that he believed that the Bristol unit was below standard on the basis of comparative outcome data. I do not recall which particular procedures he was concerned about. I do not recall that he was any more specific than that, nor that his concern was anything more than a level of "worry". I certainly retain no impression from either what Dr Bolsin said to me on that occasion, or how he said it, that there was a serious problem with paediatric cardiac services.' [28]
<< previous | next >> | back to top
Footnotes
[22] T94 p.31 Professor Prys-Roberts
[23] WIT 0382 0002 Professor Prys-Roberts
[24] T94 p.29-37 Professor Prys-Roberts
[27] From March 1991 to February 1993
[28] WIT 0170 0044 - 0045 Ms Orchard