The NHS was "cavalier" in its attitude towards seeking consent to retain tissues of patients who have died, the public inquiry into the Bristol heart babies scandal has been told.

But Mr Hugh Ross, chief executive of the United Bristol Healthcare Trust, also told the public inquiry that doctors at the hospital had done nothing wrong in retaining children's heart and other organs after they died in complex heart operations at the unit.

A week before the multi-million pound investigation began in March, the Bristol Heart Children's Action Group claimed the Trust had systematically retained children's hearts and other organs without the parents' knowledge.

The group believes as many as 180 children could have been buried with organs missing after complex cardiac operations and the Inquiry is to hear from a number of distressed parents about how they learned the truth.But he admitted the NHS generally had been cavalier when seeking consent to retain tissues after post-mortem examinations.

Mr Ross, the Trust's chief from 1995, said the law was unclear on the retention of tissue and had been the subject of debate for years.

'Too slow to change'

He said: "If I think back over a number of years it would not be unfair to say that the NHS handled this issue in a somewhat cavalier manner in the distant past.

"I think the practice has been far too slow to change and, although there was discussion over the years, the practice has not moved as fast as it might have done. Informed consent was not the order of the day which clearly it should have been."

Mr Ross said parental consent was not required if a coroner ordered a post mortem, but it was needed if a hospital carried out the post mortem and later retained organs for research or teaching purposes.

He said he had ordered a review of practice in Bristol, leading to new guidelines on consent, and he maintained the guidelines reinforced good current practice in his hospitals.

He added: "It was recognised that NHS practice was right for review and ripe for overhaul and now in all our dealings with patients and relatives we increasingly try to give much better information about what it is we intend to do for the patients' benefit."

Doctors struck off

The public inquiry follows a long-running General Medical Council probe into the scandal.

The GMC investigation examined 53 Bristol Royal Infirmary operations in which 29 patients died and four were left brain injured.

It ruled that surgeon James Wisheart and Dr John Roylance, the Trust's former chief executive, should be struck off.

A second surgeon Janardan Dhasmana was banned from operating on children for three years.

Mr Ross told the Inquiry he believed there were 179 cases of retention of hearts, lungs or other tissue during the period under investigation.