Hospital took three years to act over epilepsy consultant

A consultant who wrongly diagnosed more than 600 child-ren with epilepsy had been the subject of complaints almost three years before he was suspended, a report said yesterday.

Andrew Holton, who worked as a paediatrician at Leicester Royal Infirmary for 11 years, was suspended on full pay in May 2001. An internal inquiry at the time found that he had misdiagnosed epilepsy in 618 children and that 500 children were wrongly treated with high doses of drugs, which in some cases they did not need.

A report from a two-year inquiry by a Department of Health review panel said it had uncovered evidence of complaints about the consultant in 1995 and about his clinical practice in 1998. About 400 families have launched legal action against the University Hospitals of Leicester (UHL) NHS Trust, which could cost the health service£10m.

The new report, commissioned by the regional director of public health, said the most damning indictment of Dr Holton's practice came in a letter from his neurology specialist nurse Ann Brown in April 2000 ­ a year before he was suspended. Ms Brown, who had worked as an epilepsy specialist for 15 years, said she had concerns about his methods and the high doses of drugs children were given.

The independent panel was told that Dr Holton had an "abrupt approach, a tendency to rudeness and an apparently dismissive attitude towards parents and carers".

In 1998 Dr Alun Elias-Jones, the hospital's clinical director at the time, received letters from community paediatricians alarmed at Dr Holton's high rate of epilepsy diagnosis and the "unacceptable levels of clinical risk in children". "The cluster of correspondence addressed to Dr Elias-Jones in November and December 1998 clearly presented an opportunity to address the issues surrounding Dr Holton," states the report. "In our view, the decision not to proceed with external review at that stage was a serious error of judgement," said the report.

"Overall, we have concluded that the response of the respective NHS Trusts could and should have been more decisive at an earlier stage."

The panel said that the possibility of subjecting Dr Holton's work to an external review had been raised in 1999, but hospital managers agreed to deal with the matter in-house.

It added: "We conclude that a move to an external review should have been pursued with vigour at that time.

"The concerns expressed by the consultant community were not given the weight they deserved and we were generally disappointed at the apparent failure to react in a timely and appropriate manner."

The report prompted an immediate apology from Dr Peter Reading, the chief executive of the UHL NHS Trust.