Heart surgeons 'have learnt lessons'

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Matthew Hill BBC South West health correspondent

The mother of a baby who died during the Bristol Heart Scandal has welcomed the publication of new figures showing outcomes for cardiac patients have improved dramatically.

Maria Von Hildebrand says surgeons were forced to publish their mortality rates because of the heart inquiry - and that's contributed to far more patients surviving.

Jacinta with her older brother Sam

It's now more than twenty years since nine month old Jacinta Von Hildebrand died after heart surgery in Bristol.

Her surgeon, Janardan Dhasmana, was one of three doctors who were later found guilty of serious professional misconduct by the General Medical Council over the part they played in the scandal, where too many babies died from their open heart operations.

Ms von Hildebrand, 51, says: "The lessons learnt from the Bristol enquiry, and from all of us coming together, have been quite immense.

"So for the heart surgeons in the country, they are getting their act together. They are demonstrating an improvement in quality and safety.

"They are showing they are still taking on high risk cases, and that's very important."

Robust results

Before the heart scandal came to light , some surgeons volunteered to share their death rates with their Society of Cardiothoracic Surgery.

Any surgeon with a high mortality rate was told about it, but this important information was never shared with others, including their managers.

Professo Gianni Angelini has pioneered more open practice

Under this system 29 babies died in Bristol who, according to the subsequent enquiry, could have expected to survive.

It was then down to the Professor Gianni Angelini of the Bristol Heart Institute, with his colleagues to pioneer a better and more open system of audit.

In 1996, their team was the first in the country to publish mortality rates for open heart adult surgery to patients.

The British Heart Foundation surgeon says if the terrible tragedy at Bristol had not happened, then it would probably have taken much longer for the country to have robust surgical results available.

Gold standard

He added: "I think it's a combination of surgical and anaesthetic technique, as well as the fact that what you do is accountable, has improved the results.

"Bristol created the conditions for the surgery to be scrutinised and we published - for the first time.

Maria Von Hildebrand's baby died at Bristol

"This initiative was subsequently taken up by the national cardiothoracic society and that is why we got this report today.

"I think as cardiac surgeons we led the way and I expect other specialities will take this on and use the same criteria. There is no reason not to do that.'

And that aspiration is something the Department of Health hopes will be brought through into all specialities by 2011, when all surgeons are to be re-validated.

Cardiac audit is now the gold standard.

But robust clinical audit is expensive, and the Royal College of Surgeons is warning that with just £8 million a year made available for clinical audit it will not be possible to have similar systems up and running in all specialties.