‘Learning from Bristol’: Healthcare in the 21st Century
| Published date | 01 March 2002 |
| DOI | http://doi.org/10.1111/1468-2230.00377 |
| Date | 01 March 2002 |
‘Learning from Bristol’: Healthcare in the 21st Century
Jo Bridgeman*
The background
As early as 1986, the quality of the paediatric cardiac service at the Bristol Royal
Infirmary was the subject of adverse comment. Soon after his appointment as
consultant anaesthetist in September 1988, Dr Stephen Bolsin became concerned
about the length and outcomes of operations upon children and made repeated
attempts to secure a comprehensive investigation into paediatric cardiac services.1
It was not until January 1995, following the death whilst undergoing an operation
of eighteen month-old Joshua Loveday, that an independent inquiry of paediatric
cardiac services at the Bristol Royal Infirmary was established. Allegations of
serious professional misconduct were made to the General Medical Council
(GMC) and proven against cardiac surgeons Mr James Wisheart and Mr Janardan
Dhasmana and the Chief Executive of the United Bristol Healthcare NHS Trust Dr
John Roylance. The demands of parents whose children had undergone cardiac
surgery at the Bristol Royal Infirmary for a public inquiry were met in June 1998.2
The Report of the Public Inquiry into children’s heart surgery at the Bristol
Royal Infirmary 1984–1995 (hereafter the Kennedy Report) is the closest we will
come to a balanced account of the Bristol Story, versions of which have already
been told in newspapers, documentaries and televised drama. Yet the Kennedy
Report cautions that in the retelling of events there may be a coherence which was
lacking at the time and stresses the importance of understanding events at Bristol in
the context of the National Health Service (NHS) at the time (a period of 12 years
which commenced 14 years before the beginning of the Inquiry). Broadly
speaking, this period was characterised by an attempt to apply the model of the
market to public services, including the NHS, in an effort to maximise efficiency
and cut public spending. This model was incompatible with the foundational
principles of the NHS – ‘a publicly-funded service, free at the point of delivery,
that it provide a comprehensive service and that there be equity in people’s access
to its services’3– to which many of its employees are committed. Furthermore,
throughout the period the health service continued to be underfunded: the level of
funding was insufficient to deliver the service which the government claimed
would be provided, a matter of frustration to patients and healthcare professionals
alike.4
We only need look to recent healthcare ‘scandals’ which have caused
widespread public concern arising from the activities of individuals and about
the quality of care provided within the NHS to find similar stories. Evidence to the
ßThe Modern Law Review Limited 2002 (MLR 65:2, March). Published by Blackwell Publishers,
108 Cowley Road, Oxford OX4 1JF and 350 Main Street, Malden, MA 02148, USA. 241
* School of Law, University of Sussex.
1The Report of the Public Inquiry into Children’s Heart Surgery at the Bristol Royal Infirmary 1984–
1995: Learning from Bristol, CM5207(I) (July 2001) paras 11.4–11.14.
2ibid paras 1.11–1.14. Announced by Frank Dobson, then Secretary of State for Health, Ministerial
Statement to House of Commons, June 1998 (Hansard Col 529–530). The panel members were
Professor Ian Kennedy (Chair), Rebecca Howard, Professor Sir Brian Jarman and Mavis Maclean.
3ibid para 21.9.
4ibid para 4.31.
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