News & Insights: Healthcare

Belfast Neurology Patient Recall: Should a Public Inquiry be held?

7 October 2020

The recent announcement from Robin Swann, Minister for Health, of a full public inquiry in respect of the abuse suffered by patients of Muckamore Abbey Hospital is both welcome and necessary. It is imperative that a full and robust investigation takes place to ensure that lessons are learned and that such an event never happens again.

Another recent crisis in Northern Ireland healthcare is the Belfast Health and Social Care Trust patient recall. To recap, approximately 3,000 patients have been recalled to date, and recent figures suggest that up to 600 patients have been advised that they were misdiagnosed by Dr Michael Watt, Consultant Neurologist. This represents around 1/5 of all patients recalled.

There are ongoing proceedings before the General Medical Council, which regulates the fitness to practise of doctors. There is also a Neurology Inquiry ongoing which is chaired by Mr Brett Lockhart QC. In addition, the Regulation and Quality Improvement Authority (RQIA) are investigating governance issues in the Belfast Trust, as well as reviewing the medical records of all patients or former patients of Dr Watt who have died in the last 10 years. No reports have been produced to date.

While some form of inquiry is ongoing, it is an independent non-statutory inquiry. Importantly, there is no obligation on the government to publish the ultimate report that will be produced in due course. That can be contrasted with a full public inquiry pursuant to the Inquiries Act 2005.

Inquiries Act 2005

A Minister may cause an inquiry to be held under this legislation where it appears to them that “particular events have caused, or are capable of causing, public concern.”

Based on the above definition, there would appear to be strong grounds for a public inquiry in respect of the patient recall. As stated above, approximately 3,000 patients were recalled. Of that, it is estimated that 1/5 were advised they had been misdiagnosed. Many of these patients will have suffered harm due to unnecessary treatment. This does not factor in patients who are deceased, who may have suffered misdiagnosis or substandard care before their death. The level of concern was sufficient to lead to a BBC Spotlight programme which shed further light on worrying issues. The programme revealed that Dr Michael Watt was performing a procedure called an epidural blood patch at a rate that far exceeded any other NHS trust in Northern Ireland or the UK. Other concerns relate to misdiagnosis of conditions like stroke, epilepsy, multiple sclerosis, and motor neurone disease.

Governance Concerns

A further, and extremely worrying, aspect of this recall is that there would appear to have been limited, if any, supervision in relation to the clinical practices of the consultant involved. There are clearly governance issues in respect of how this practitioner was able to practise in Northern Ireland for so long without any concerns being made public or any restrictions in place. That needs to be investigated fully not only to understand what has gone wrong in relation to the recall, but also to ensure that no similar event takes place in another field of medicine.

Who can call for an Inquiry?

Ultimately, it is the responsibility of patients who have suffered, or their families, to apply public pressure to hold an Inquiry. Certainly, the Belfast Trust patient recall would appear to fit squarely within the statutory definition to warrant such an Inquiry.

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