Bristol Royal Infirmary staff worked in an atmosphere of fear that 'pervaded every aspect of the organisation', a senior manager has claimed.
Rachel Ferris, general manager of the directorate of cardiac services, told the Bristol Royal Infirmary inquiry last week that 'staff were frightened to raise their concerns'.
Ms Ferris, who joined United Bristol Healthcare trust in November 1994, told the inquiry into the deaths of babies who had complex heart surgery at the infirmary in the 1980s and early 1990s, that 'managers would watch to see who was in favour, and those who were not were avoided'.
She said staff were particularly wary of director of operations Margaret Maisey, whose role was 'controlling the general managers in order that (chief executive) Dr John Roylance could get on with other things'.
Ms Maisey described herself as the 'Rottweiler of the trust', Ms Ferris told inquiry counsel Brian Langstaff QC.
'Where staff did raise concerns, they were either belittled or reprimanded. Or comments were made to undermine their credibility and motives.'
The inquiry is currently taking evidence about the management of the infirmary. It will hear evidence of who knew about problems with paediatric cardiac surgery - and when - later this year.
But asked 'who we are talking about' with her reference to people's credibility being undermined, Ms Ferris cited 'whistleblower' Dr Stephen Bolsin and the trust's current associate clinical director, Professor Gianni Angelini.
Ms Ferris told the inquiry that the trust 'was lacking in strategic direction' and had 'a real abhorrence of anything that was considered to be process management' when Dr Roylance was chief executive. She also said that waiting lists were very long when she took up her post, but the trust seemed 'reluctant' to invest in cardiac services.
Roger Baird, a vascular surgeon who later became the trust's medical director, said management was 'pretty reactive' rather than proactive in asking people to come forward with concerns.
He told the inquiry that people would have been 'concerned about their standing, about their professional reputation' if they had become whistleblowers.
Peter Durie, chair of Bristol and District health authority and later of the trust for almost 10 years, said there were 'very many routes of varying formality available to anyone in UBH trust to raise concerns if they wished'.
He said that 'with hindsight, knowing there was this information that Dr Bolsin had, which I never got to know of', it might have been a good idea to 'set up a number you could ring anonymously... but I did not think of it at the time'.
Mr Durie said he would have expected 'somebody at the centre' to be monitoring surgical outcomes and to inform him of any problems they revealed.