His self- belief is not careless but painstaking founded on a meticulous attention to detail He is

His self- belief is not careless but painstaking, founded on a meticulous attention to detail He is no rogue doctor. Even the GMC, in striking him off, described him in its verdict as "caring and dedicated". All I will say is this: they are building a new children's hospital in Bristol at a cost of £21m. "You can say that managers didn't provide the money, but they are in an impossible position - facing demands in all directions. You can't down tools if you don't get what you think patients should have I think this issue is a microcosm of the NHS. If you scratch the surface you would find people struggling to do their best with the resources they have."So is the public inquiry - which is due to report later this year, and which has already sat for 95 days, heard 140 witnesses and taken thousands of pages of evidence - a complete waste of time?"I wouldn't presume to comment.

Wherever high death rates were apparent, he says there were reasons, and although improvements could have been made in the facilities, that was true throughout the NHS. "No one has been able to say either to the GMC or to the public inquiry that they can identify a concrete difference that would have resulted [from such improvement]," he says. He dismisses as "preliminary" a statistical report presented to the public inquiry, which showed Bristol's death rate to be twice the average for the 12 specialist units, saying it was "alarmist" and based on "inadequate data".Despite his eloquent defence, however, Mr Wisheart acknowledges that heart-operation results have improved since he retired. Paediatric heart surgery was transferred from the Bristol Royal Infirmary to the Bristol Children's Hospital, the facilities were upgraded and a dedicated children's heart team was appointed. Does all that not conflict with his claims?"To some extent it does I think the composite package has achieved improvements. That is something I feel very positive about, even though it was achieved after my time."So why were the Bristol surgeons not able to secure such improvements earlier? The problem, he claims, was lack of finance. Bristol was designated as one of 12 specialist paediatric heart units in 1984, but resources were tight, facilities were poor and there was no dedicated paediatric heart surgeon until 1995.Mr Wisheart defends his unit as he defends himself.

I never claimed to be the best surgeon in the world but I do believe my work has been acceptable. I felt the defence I offered was convincing and real and not a delusion."Friends say he and his fellow surgeon Mr Dhasmana have been made scapegoats for wider failings at Bristol involving the whole surgical team and an institutional culture that was insular and inward-looking. In addition, he pointed out, such operations accounted for only 3 per cent of his paediatric work, and no one suggested the other 97 per cent was not satisfactory."I examined the facts and examined myself repeatedly and repeatedly and repeatedly. I was not a quick surgeon, but by being painstaking and careful some of the effects of that can be mitigated."To be hauled before the GMC was shattering, but he had continued to believe until close to the end that once the reasons for his poor run of success with the hole-in-the-heart operations had been explained, he would be exonerated. When I put that to him, his response was typically meticulous. "My own view of my own speed of surgery is that I was a slower-than-average surgeon I think this has been exaggerated and distorted.

If you consider all the factors, I believe I was treated extremely harshly by the GMC. I don't believe they took account of the additional factors."Mr Wisheart has an answer to every accusation thrown at him. It was alleged that he was slow as a surgeon - operations were taking too long, putting babies' lives at risk. So I wasn't alarmed; I continued to feel at that stage that was satisfactory. Nine of the children died, giving him a mortality rate of 60 per cent. Mr Wisheart argued that 11 of the 15 had complications and three were inoperable, though that became clear only on the operating table."It therefore appeared there were reasons why these children died. That argument formed the core of his defence against the GMC.