Neurology Inquiry: Report makes 76 recommendations after NI's biggest-ever patient recall

launch of the Independent Neurology Inquiry report
Author: Nigel GouldPublished 21st Jun 2022
Last updated 21st Jun 2022

The Belfast Health Trust could and should have intervened earlier in the work of a consultant at the centre of Northern Ireland's largest recall of patients, a report found today (Tuesday).

The Independent Neurology Inquiry report also found that systems and processes in place around patient safety failed in terms of Dr Michael Watt's work.

A patients' recall began in 2018 after concerns were raised about the Belfast-based neurologist's clinical work.

More than 4,000 of his former patients attended recall appointments.

Almost a fifth of patients who attended recall appointments were found to have received an "insecure diagnosis".

The final report following the Independent Neurology Inquiry found that problems with Dr Watt's practice were missed for years and opportunities to intervene were lost.

It makes 76 recommendations to the Department of Health, healthcare organisations, General Medical Council and the independent sector.

"While one process or system failure may not be critical, the synergistic effect of numerous failures ensured that a problem with an individual doctor's practice was missed for many years and, as this inquiry finds, opportunities to intervene, particularly in 2006/2007, 2012/2013, and earlier in 2016 were lost," the inquiry found.

The inquiry, led by Brett Lockhart QC, examined whether there were complaints or concerns which should have alerted the Belfast Health Trust to instigate an earlier investigation.

It concluded that the trust could and should have intervened earlier but failed to do so.

However the report also finds the failings identified were not confined to the trust.

"The inquiry has concluded that the combined effect of an inadequate investigation into a highly relevant clinical complaint in 2012 by the regulator (the General Medical Council); the failure to disclose significant complaints by the Ulster Independent Clinic, where Dr Watt had a substantial private practice; alongside failures of other HSC trusts to identify a pattern of concern was a conspicuous problem in the Belfast Trust," the report finds.

"Generally, the inability of the systems then in place to identify a pattern of concern was a conspicuous problem.

"Information was essentially retained in silos.

"Communication between different organisations and between management levels within organisations was poor and inadequate."

The report also found that while not every step take after November 2016 was correct, the inquiry panel believes the Belfast Trust got key decisions right after that date.

Those included the partial restriction of Dr Watt in December 2016, the commissioning of a report into his practice by the Royal College of Physicians, the full restriction of his practice in July 2017 and the decision to initiate a large-scale patient recall in May 2018.

"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 the significant detriment of patients," the report added.

Almost a fifth of patients who attended recall appointments amid concerns about the work of a Belfast-based neurologist received an "insecure diagnosis", a final outcomes report undertaken by the Department of Health and published earlier in June found.

Former patients of Dr Watt emerged from Law Society House following the publication of the independent neurology inquiry report to applause.

Jean Garland said they are grateful to have got to this day, describing a lot of hard work to have done so.

"We're grateful for the work that has been put in, we're not really surprised that there were complaints way before 2016 and that the Belfast Trust has failed us by not acting on those complaints," she said.

"If they had acted when those complaints happened, we wouldn't be standing here today ... a lot of people here today know that they would never have had the traumatic experiences that they did have if the Belfast Trust had done its job."

Asked who do they blamed, Danielle O'Neill responded: "Michael Watt failed us, the Belfast Trust failed us, the department of health failed us, the GMC failed every single patient caught up in this scandal.

"They should all do the honourable thing, hang their heads in shame and resign."

Therese Ward, another former patient of Dr Michael Watt, said the report is not the end of the road.

"This is the beginning, we have been harmed by inaction and we now know that the Belfast Trust had the information that would have prevented the harm to all of us, it had the information and sat on it," she said.

"We want accountability, not just corporate accountability, we want personal accountability where people who have allowed harm to us are personally held accountable."

Jean Garland added: "This is just a report, now we need action and we need people in power and our politicians have a big role to play here to push to get this to happen."

Danielle O'Neill said she felt health minister Robin Swann should have been present for the publication of the Independent Neurology Inquiry report.

"He should be standing here alongside us, where is Robin Swann today," she said. Ms Ward added: "And where is Michael Watt."

Health Minister Robin Swann apologised unreservedly for the hurt caused.

A number of separate inquiries have been taking place into the work of Dr Watt, who formerly worked for Belfast Trust at the Royal Victoria Hospital.

Last year, he was allowed to voluntarily leave the medical register before a General Medical Council hearing could be carried out into his actions.

This means he can no longer practice medicine in the UK.