Former NHS trust chief executive Dr John Roylance has denied any knowledge of problems with child heart operations at Bristol Royal Infirmary (BRI).

He has also warned that the public outcry following the exposure of high child death rates at the hospital could lead to doctors refusing to treat high-risk patients in future.

There is a very real risk that high-risk babies may be deemed inoperable when in the past they may have been deemed operable

Dr John Roylance, former BRI chief executive

Dr Roylance was giving evidence to the public inquiry into care at the BRI heart unit.

He said: "I very much regret that I was never put in a position to prevent any avoidable deaths.

"I very much regret that nobody ever made it known to me that the service was not merely ripe for improvement and requiring improvement but was ever thought to be unacceptable.

"I really cannot pick any point when the information given to me was other than `you must do your very best to improve the service'."

The former hospital chief also expressed his profound sadness to the families whose children had died.

He said: "My heart goes out to all the parents of babies who died in complex heart surgery at the Bristol Royal Infirmary.

'I feel the loss acutely'

"As a person who spent over 40 years in healthcare, who is the father of four children and the grandfather of six, I understand the tragedy of the loss of a child very acutely."

Dr Roylance, head of the United Bristol Healthcare NHS Trust until 1995, was struck off the medical register last year for serious professional misconduct following a General Medical Council investigation into complex heart operations on 53 babies, 29 of whom died.

He told the inquiry: "I don't look to this inquiry to reveal my personal innocence or to the panel to exonerate me.

"I am unimportant in this, but I do hope they will be able to find a way of preventing this happening without the very real risk of high-risk patients not being treated, lest the poor outcome produces improper criticism.

"There is a very real risk that high-risk babies may be deemed inoperable when in the past they may have been deemed operable."

Asked by inquiry counsel Brian Langstaff QC whether he might have "taken his eye off the ball" when it came to paediatric cardiac surgery, Dr Roylance replied: "If someone would come and tell me they are killing children in cardiac surgery and I hadn't noticed, that would be quite unthinkable."

The inquiry, which began in March, is now considering nearly 1,900 cases of operations on heart babies.