The inquiry will look far beyond events at Bristol Royal Infirmary.

It will progress in two phases. Phase one will take oral evidence to try and establish who knew what when about Bristol between 1984 and 1995.

These hearings are expected to last until the end of 1999.

Phase two will look at the wider issues raised and if lessons learned can be translated into action within the NHS as soon as possible.

Key questions must be:

• Who will police doctors?
• Can the profession continue to regulate itself?
• How do we get over the problem of surgeons undertaking new procedures having a learning curve?

The Senate of Surgery of Great Britain and Ireland has announced a series of measures which it believes will address this issue, but the results for individual surgeons will still be kept out of the public domain.

Skills will be tested in future

The General Medical Council has also decided to introduce revaloidation - or MOTs - for doctors.

Specialists will in future need to prove their skills are up to date or else lose their right to practise.

But this system is unlikely to be in place in the immediate future, and there are now calls for a medical inspectorate which would be impartial and identify poor clinical practice.