The
Bristol Royal Infirmary Inquiry into neonatal cardiac surgery
fatalities was set up in 1998. Its
report is imminent. Mr.
James Wisheart, one of the three accused surgeons at the heart
of the affair, gave a series of interviews in the second half
of 2000 to Hospital Doctor which taken with evidence aired
in both paper and electronic BMJ articles and Letters to the
Editor make compelling reading; for me compelling a feeling
that injustice rather than justice was the outcome of the GMC
hearing of the three medical practitioners accused. Early
last year in Hospital Doctor (20 Jan 2000) a consultant psychiatrist,
Dr John King, expressed his unease at the published account
of Mr. Dhasmani who early in the Bristol Inquiry cried openly
in the witness box. Dr King was reminded of those scenes from Stalinist Russia,
the notorious show trials where people came forward, guilty
or not, to beg forgiveness. Having
confessed they were not forgiven and were sent to their fate. Dr
King asked, surely this couldn't happen in England? Mrs.
Wendy Savage, a respected obstetrician and gynaecologist, who
was herself the focus of General Medical Council (GMC) proceedings
in a quite separate investigation, eventually emerging victorious
in 1986 and now a member of the GMC, has expressed grave misgivings
about that body's performance in relation to the Bristol accused
(BMJ 5 Dec 1998). Emeritus
Professor Peter Dunn, a neonatal paediatrician, (another highly
respected figure), also publicly expressed concern about GMC
process and quality of evidence of certain witnesses, (including
that of so-called "whistleblower" Dr Stephen Bolsin), in several
BMJ contributions between October 1998 and April 1999. Another
remarkable feature was the experience of Dr Nick Barnes (BMJ
5 December 1998 an absolutely "must" read). He was invited
by the public inquiry chairman to become a member of the Bristol
public inquiry panel set up after the GMC hearing. Subsequently
he was told his services would not be required. He
received no explanation for the unexpected rejection. Now
Dr Barnes is a consultant paediatrician. Nonetheless, he had
soul-searched not only his own suitability for the task foreseen.
He had wondered following his being approached initially and
before meeting the chairman at the composition of the panel;
had voiced his concern, inter alias, at the absence of a surgeon
on it. Rather like a plumbers' policy convention without a
plumber (this particular reflection is mine, not Dr Barnes). It
has also been difficult to escape the conclusion that the worst
possible interpretation of the evidence and the whole Bristol
Affair has not been unwelcome to government. Health Secretary
Milburn had bracketed the infamous Harold Shipman murders with "Bristol",
as if the two were in any significant way comparable. He reiterated
political clichés about the need for tighter controls
on regulation of doctors. Doctors of course are the most informed
(and therefore most troublesome) critics of NHS systems` deficiencies,
and politically expedient short-term solutions - solutions
for politicians that is: less so for patients. So,
who better to select as chairman of a Bristol Inquiry than a
person, a lawyer naturally. What didn't until recently cross
was just who Professor Kennedy might be until I looked up his
entry in Who's Who 2000. What had been the longest shot in my
vast armoury of paranoia about the virtual persecution of our
profession by successive governments scored an amazing hit. The
chairman was a prominent eccentric, self-promoted, uniquely paranoid
(even by my standards) about the medical profession. Am
I suggesting that Professor (of health law) Ian Kennedy is an
unsuitable chairman of the Bristol Inquiry? Most certainly. He
(despite being a lay member of the GMC and apparently highly
thought of by GMC president, Sir Donald Irvine) held peculiarly
hostile and public views on the medical profession as a whole
even two decades ago. Again, I must aver my belief that Professor
Kennedy is wholly within his human rights (and I would strongly
support that right) to hold them though I might profoundly disagree
with them. In saying that, I am not suggesting all doctors are
sweetness and light. Clearly, they are human with its real and
implied frailty. Professor Kennedy gave the BBC Reith Lectures (1981), 'Unmasking Medicine', suggesting a devilish plot by the profession against the laity, and titled the first in the series, "We must become masters of medicine, not its servants". The
distinguished international statesman and historian, and, at
that time editor of The Observer, Dr Conor Cruise O'Brien, commented
(The Observer Jan 25, 1981), "sounds good but who are 'we'
supposed to be? "......Mr. Kennedy says that medicine is too
important to be left to doctors. Very well, but if mastery of
medicine is to be taken off the doctors and given to some other
people, then I should very much like to know, please, who those
people are......Mr. Kennedy doesn't tell me." It
is difficult to fault the logic of Cruise O'Brien, nor indeed
to divine that he found that lawyer's perception of the medical
profession to be somewhat odd. It appears to me that a less appropriate
chairman (make no mistake a powerful and influential position)
for that Bristol inquiry would be hard to find. Unfortunately
it is perhaps late in the day for Professor Kennedy to consider
the suitability of his position. But his chairmanship does make
it difficult for both public and the medical profession to repose
their confidence in any report from a committee chaired by such
a uniquely prejudiced person for the matter under examination. Remember
General Pinochet? One
person I suspect who most definitely wishes to forget him is
Lord Hoffman. He was the senior Law Lord whose decision on the
Pinochet case was found to be...well,...unsafe. The reason was
that he had some rather tenuous connection with Amnesty International
and it was posited that this might well have prejudiced his views
in the case of the General. Lord Hoffman, doubtless also an honourable
man felt he must step down and the whole judicial process started
all over again. The rest is legal history. It
hardly takes a quantum leap to see the relevance of General Pinochet
for Bristol. Dr
Dermot Ward
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