The lawyer representing families affected by the Bristol heart babies tragedy has lambasted managers for trying to pass the buck at the Bristol Royal Infirmary inquiry.

In closing submissions, Harry Trusted, counsel for the Bristol Heart Children's Action Group, said the inquiry's own researchers had looked at 80 cases and found 13 in which children received substandard care that could have affected the outcome of treatment. Of these 11 died and one was permanently disabled. The group estimates that 50100 children died because of 'mismanagement and bad care' at the hospital in the 1980s and early 1990s.

Mr Trusted said blame lay with the three doctors stuck off or disciplined by the General Medical Council in 1998, managers, and the 'woeful failure' of external monitoring bodies. A most distressing aspects of the evidence 'was that not one of the people in charge of those bodies was prepared to come to this inquiry and say, 'Yes it was us. We should have done something and we did not.' They were all anxious to blame the other guy somewhere along the line.'

But Rohan Pirani, counsel for the Department of Health, said that while 'we will not decline to accept criticism where justified' much of the evidence presented to the inquiry 'is coloured somewhat by the benefit of hindsight', particularly on quality and audit. He said people who claimed to have been aware of the problems should have approached the DoH directly.