The Department of Health knew there were problems in the children's heart unit at the Bristol Royal Infirmary three years before any official action was taken, according to a BBC investigation.

Three doctors from the BRI face being struck off after the deaths of 29 babies in their care between 1988 and 1995.

In the biggest ever medical disciplinary inquiry, the cases against two cardiac surgeons - James Wisheart and Dr Janardhan Dhasmana - and their manager, Dr John Roylance, were proven before General Medical Council on Friday, May 29.

The BBC's Panorama programme has named Dr Norman Halliday as the Department of Health official who, as early as 1992, learnt about the higher-than-average death rates at the Bristol unit.

It was his job to oversee Bristol and the other specialist units. He is now retired and agreed to speak to Panorama, despite being advised not to comment on the matter by the DoH.

Dr Halliday said: "It [Bristol] never got off the ground, there always was problems with Bristol�I wouldn't say it wasn't working but it wasn't as strong or as viable as other units."

No recommendations

Panorama has disclosed a report commissioned by the Department of Health in 1989 which revealed that the Bristol unit had fewer-than-average children referred to it and that it also had the highest number of deaths of the nine national children's heart units. However, the report failed to recommend any further investigation of the poor statistics and instead recommended that Bristol "be encouraged to increase their numbers annually".

Sian Collyer died after a heart operation

The programme has also revealed that other children's heart specialists knew as far back as the early 1980s of problems in Bristol. Professor George Sutherland was a cardiologist in Southampton in the 1980s and was aware of concerns within the profession about Bristol surgeons' ability to perform complex children's heart surgery.

He told the programme: "From the time I was appointed in 1983 as a children's cardiologist there were, within the profession, some doubts about the quality of cardiac surgery being performed in Bristol and certainly worries about the mortality figures in young children

"... there was a perception throughout the region and children were leaking out to other centres ... rather than being surgically treated at Bristol."

No guarantees

Panorama has also speaken to the doctor responsible for initiating the inquiry into the deaths at the BRI, who believes that the scandal could be continuing in other hospitals around the country.

Stephen Bolsin: it could still be happening

Since being revealed as the whistle-blower for his part in exposing the scandal at Bristol, Dr Steven Bolsin has moved to Australia. Dr Bolsin told Panorama: "I think one of the saddest things about this whole incident is that there is no guarantee that it is not happening now in the NHS in Britain in some hospital near you."

He adds: "It's completely beyond me that the Department of Health is unable to establish [this] kind of policing in the 1990s and nobody in the NHS can give you any kind of reassurance that it's not actually happening as we talk."

Unnecessary deaths

Dr Michael Rigby, a paediatric cardiologist at the Brompton Hospital, has closely examined the medical notes of all the children being examined in the Bristol case.

He is convinced some of the children should still be alive today: "Some children who died would have survived had they been operated on in another centre by a surgeon with a lower mortality rate."

One of the nurses who accompanied many of the parents as they took their children to the operating theatre told the programme how she wanted to voice her concerns about the surgeons operating at the BRI.

She says that there was a sense amongst the nurses generally that "we've let the baby down". Helen Stratton tells the programme there were times when: "I wanted to pick up the baby and just run out of the operating theatre, bundle it into the car with the parents and take them anywhere else."