Parents of children who died after heart operations at Bristol Royal Infirmary have welcomed news of the scope of the independent public inquiry into the case.

The inquiry will be much wider than an earlier inquiry by the General Medical Council.

Twenty-nine young patients died at the hospital following surgery - a much higher rate than average.

Three doctors were found guilty of serious professional misconduct in relation to the case, which has provoked much soul-searching in the medical profession and new guidelines on regulating specialist treatment.

Health Secretary Frank Dobson said the inquiry, which will be formally opened in Bristol in the autumn, will look at the management of care of children receiving complex heart surgery at the hospital between 1984 and 1995 and "relevant related issues".

This means it will be wider than the scope of the General Medical Council inquiry - the longest in its history - which finished in June and whose outcome was criticised by Mr Dobson.

'Not wide enough'

It examined 53 cases between 1988 and 1995 and ended in the banning of two doctors - surgeon James Wisheart and manager Dr John Roylance - and the suspension of another, Dr Janardan Dhasmana.

Malcolm Curnow: "Parents want the truth"

Parents of the children who died at BRI criticised the inquiry, saying it did not go wide enough and did not look into all the cases of children who suffered severe brain damage following surgery.

Protesters outside the GMC hearing held up a list of 150 children they said had been affected by treatment at BRI.

The GMC hearing was also criticised for failing to examine the hospital's record on adult surgery.

Accountability

Malcolm Curnow, of the Bristol Heart Support Group whose nine-month-old daughter Verity died after a hole-in-the-heart operation in 1990, welcomed the inquiry.

He said the inquiry would look at around 1,500 operations, double the amount of operations of the GMC inquiry.

"It will give a much more accurate representation of what was going on at that time," he said.

"Parents want to know the truth of what happened and why no action was taken to stop the proceedings going ahead. This is their best opportunity to get to truth of what happened."

He added that parents wanted a proper sense of accountability for the problems at the hospital, including managers, other health staff and Department of Health officials..

Dr Stephen Bolsin: there is a wider net of responsibility for the deaths

Dr Stephen Bolsin, the anaesthetist who blew the whistle on the case, also welcomed the inquiry.

But he thought it should go back further than 1984 since concern began to be expressed earlier.

He said it was possible a "wider net of responsibility" would be uncovered by the inquiry. "It is possible that a lot of people will have to answer quite searching questions to establish the wider net of responsibility for the unnecessary deaths that occurred," he stated.

He also called for the hospital's record on adult heart surgery to be taken into account.

Cynthia Williams (right) died after bypass operation

James Wisheart is reported to have had a death rate for adults which was four times higher than the national average. Cynthia Williams died at BRI after a triple heart bypass operation.

Her husband Shaun said: "You still continue to wonder, but now it seems this is something we shall never really know."

Ethics

The inquiry will be chaired by Professor Ian Kennedy, professor of health law, ethics and policy at University College, London.

He will be joined by Mavis Maclean, a senior research fellow at Wolfson College, Oxford, and an academic advisor to the Lord Chancellor's Office, and Rebecca Howard, executive director of nursing at the Manchester Children's Hospitals NHS Trust. Ms Howard has contributed to national policy development on child health care.

They will be joined by a medical expert to be announced shortly.

The inquiry will examine the adequacy of the heart surgery services provided; how staff and managers dealt with concerns about treatment; and any failure to take appropriate action promptly. It will make recommendations that will have implications for treatment across the NHS.

Although hearings will not begin until next year, the panel is already gathering documentary evidence. BRI managers say they will cooperate fully with the inquiry.

So far, the Bristol case has prompted the government to announce the publication of hospital mortality league tables so that the public can measure how well a hospital performs in specific treatments.

Doctors' organisations have also announced new guidelines on the self-regulation of doctors.