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Neurology Inquiry: Health bodies criticised over failure to act on Dr Watt fears

Opportunities missed over a period of years to identify problem with consultant, finds inquiry


Dr Michael Watt

Dr Michael Watt

Dr Michael Watt

A “catalogue of missed opportunities” and numerous system failures led to the recall of more than 5,000 patients across Northern Ireland, a public inquiry has found.

The Independent Neurology Inquiry has issued an excoriating assessment of the role of the Belfast Trust, General Medical Council (GMC) and Ulster Independent Clinic (UIC) in the Dr Michael Watt neurology scandal.

The inquiry was established to examine governance within the health service as serious concerns emerged over the clinical practice of the former Belfast Trust consultant neurologist leading to the recall of 5,448 patients — the biggest ever NHS patient recall.

Publishing the findings on Tuesday morning, chair of the inquiry, Brett Lockhart QC, said: “Were patients let down? The inquiry panel believes that they were.

“Were opportunities missed over a period of years to identify a problem with Dr Watt’s practice?

“Again, the answer is yes, and this report outlines in great detail those opportunities.

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“Would earlier intervention have made a difference? The inquiry panel believes that it would have done.”

Mr Lockhart QC said the inquiry panel had identified 12 specific occasions between 2011 and 2016 where concerns were raised by a variety of people — including GPs, registrars, consultants outside the Belfast Trust, and a nurse — but it was only when an issue was finally brought to the medical director in November 2016, that action was taken.

He said had the “numerous concerns, complaints and circumstances” been properly investigated, they “would have uncovered a significant problem at a much earlier stage”.

He explained: “What the inquiry found, prior to November 2016, was a catalogue of missed opportunities, systems that did not work effectively, a culture which discouraged the escalation of concerns. The inquiry panel has concluded that the Belfast Trust could and should have intervened earlier but failed to do so over many years.”

He said decisions to place restrictions on Dr Watt’s practice in July 2017 and initiate a patient recall in May 2018 were appropriate, but continued: “Patients will, however, rightly point to the many years when problems that emerged with Dr Watt were not addressed, opportunities were missed, and such inaction was to their significant detriment.”

Referring to the GMC and UIC, Mr Lockhart QC raised serious concerns over a failure to act when questions arose over Dr Watt’s clinical practice.

The inquiry singled out an “inadequate investigation into a highly relevant clinical complaint in 2012” by the GMC and a failure by UIC to tell the Belfast Trust about “significant complaints” as issues of significant concern.


Inquiry chair Brett Lockhart QC delivers the findings of the report

Inquiry chair Brett Lockhart QC delivers the findings of the report

Kelvin Boyes / Press Eye

Inquiry chair Brett Lockhart QC delivers the findings of the report

Mr Lockhart QC also said there was a failure by medical professionals “to appreciate that aberrant practice was happening in plain sight”.

Reacting to the inquiry report, former patients said they believed people had come to harm as a result of failures to act to address multiple concerns about Dr Watt’s work.

The report, which is made up of five volumes and contains numerous patient accounts, makes for harrowing reading.

One former patient told the inquiry that Dr Watt incorrectly diagnosed her with the fatal neurological condition, motor neurone disease (MND), within 15 minutes of meeting her.

“Without hesitation he told me that he believed that I had MND, which is one of the most horrible diagnoses that exists… the diagnosis was pronounced with such surety. There were no ‘ifs’ or ‘buts’.”

The patient, who was a nurse at the time, revealed that after the diagnosis, she spent almost £10,000 to renovate her home as she prepared for her condition to deteriorate.

She also ‘banked’ her voice digitally for when she would no longer be able to speak, discussed how she would be fed through a tube and made palliative care decisions, as well as explaining MND to her grandchildren.

She said: “I have been angry at myself for being gullible and believing Dr Watt.

“I have blamed myself for not asking for a second opinion.” The wife of a former patient told the inquiry of her distressing encounter with Dr Watt at the UIC as he diagnosed her husband with MND.

She explained: “He said, ‘He’s got MND’. I asked about what happens now and he said, ‘If there’s anything you really want to do, do it now.’

“Then he said, ‘I’ll get you into the Royal at the beginning of next week to do some tests, because you’re going to need a breathing machine and a feeding tube peg put into your stomach.’

“We were out of the office and back into the car within 10 minutes. His whole attitude was cold and flippant. My husband and I were struck dumb, having just been given the devastating news that my husband had MND and we knew it was an incurable, terminal condition.”

Patrick Mullarkey from O’Reilly Stewart Solicitors said: “For the many patients we represent, the reported failures in care have consumed years of their lives, have frustrated the proper diagnosis and treatment of their conditions and have caused untold upset and distress.”

He described the “belated recognition” of failings in management as “cold comfort to the many patients who were at the sharp end of deficient clinical care”. David Galloway, director of the MS Society in Northern Ireland, said many patients “remain isolated, traumatised and without an avenue for either redress or to have their experiences heard in public”.

He said it is essential the inquiry report acts as a “wake-up call” for health professionals and NHS officials.

Dr Cathy Jack, the Belfast Trust chief executive, has welcomed the publication of the report as she acknowledged the distress and harm that has been caused to patients.

“The Belfast Trust let you down and many of you have suffered avoidable and unnecessary harm as a result,” she said.

“Whether that was through being given a diagnosis that was not correct, receiving incorrect treatment or medication, or having a procedure you did not need. For that I am truly sorry.”

A spokesman for UIC said recommendations relevant to the clinic will receive the “utmost attention” and that medical governance procedures have already been reviewed and strengthened.

A GMC spokeswoman said a number of improvements have already been made but added: “We know there is work to do and we will not shy away from this task.”

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