The senior surgeon at the centre of the Bristol heart babies scandal has admitted that there were question marks over his operating skills.

Mr James Wisheart is making his second appearance before the public inquiry into baby deaths at Bristol Royal Infirmary.

He told the inquiry that he had stopped performing hole-in-the-heart surgery on babies in 1994 because of the "anxiety and emotional investment" had weighed heavily on him.

However, he said that he felt that the deaths of high numbers of children on his operating table were due to factors outside his control.

Mr Wisheart, struck off the medical register by the General Medical Council (GMC), has told the inquiry that he might, in retrospect, have stopped performing surgery earlier had he realised that he was performing poorly.

He said he wanted to appeal against the GMC verdict, but had been advised that he would lose.

Mr Wisheart: 'anxiety and emotional investment'

"I felt my surgical skills had achieved a great deal, but it was clear some aspects of those skills were under criticism.

"I think my own view was that I had done my best, but on what appeared to the figures and judgement at that time there was at least a question mark over whether my skills had been what I hoped they would be."

Mr Wisheart also answered questions about the high death rates he experienced in adult cardiac surgery.

This the first of four days of evidence from Mr Wisheart.

The inquiry has already heard from Janardan Dhasmana, the second surgeon disciplined by the GMC.

He broke down in tears as he expressed his regrets to bereaved parents sitting a few yards away.

The inquiry has heard how Bristol had the highest death rates for paediatric cardiac surgery in the country - 12 times higher than the best unit.

However, a detailed examination revealed many deaths were due to poor care outside the operating theatre.

Dr John Roylance, the former chief executive at the hospital, has told the inquiry that it was not part of his role to interfere in clinical issues such as success rates for operations.

Struck off

The allegations centre on two types of operations - those to correct "hole-in-the-heart" defects, and "switch" operations, which swap the positions of two tiny arteries leading into different chambers of the heart.

The Bristol Royal Infimary had high death rates for some operations

The heart of a new-born baby is approximately the same size as a small plum, and "switch" operations have only been attempted in the last 15 years.

Mr Wisheart was struck off after the General Medical Council ruled that he did not stop operating, despite being aware of his, and Mr Dhasmana's, poor results.

He is also expected to face further questioning on whether he kept babies' hearts following death without obtaining consent from the parents, which is legally required in some circumstances.

The issue of "organ stripping" is now the subject of a separate nationwide inquiry after it was revealed that Alder Hey children's hospital in Liverpool had retained 850 hearts and other organs, with many parents claiming proper consent had never been obtained.

Inquiry chairman Ian Kennedy has said that he hopes that the legal status of organ-use after death can be clarified.