Patient abuse no bar to doctor's rising career

NHS inquiry: A senior hospital consultant criticised for neglecting the elderly in a scathing Government report is promoted to a higher post

A hospital consultant accused of neglecting his duties in an inquiry report into the abuse of elderly patients, published today, has since been promoted to a senior post in the NHS trust where the abuse took place.

A hospital consultant accused of neglecting his duties in an inquiry report into the abuse of elderly patients, published today, has since been promoted to a senior post in the NHS trust where the abuse took place.

Dr Chris Hallewell, in charge of mental health services at the North Lakeland Trust, in Carlisle, has escaped disciplinary action for his role in the scandal despite being the subject of withering criticism in the report by the Commission for Health Improvement (CHI).

The commission, set up by the Government to monitor standards in the NHS, was called in to investigate the systematic abuse of elderly patients who were, over several years, bullied, sworn at and tied to commodes while being fed.

Its report, revealed in The Independent yesterday, concluded that there had been an "almost complete absence of effective management" which allowed the abusive practices to flourish.

The Chairman and the Chief Executive of the trust have been sacked and senior managers disciplined. But Dr Hallewell, who was the consultant in charge of the wards at Garlands Hospital, where the abuse took place, was promoted earlier this year to Associate Medical Director of the trust.

The commission's report reserves some of its strongest criticism for Dr Hallewell, identified only as the associate medical director with responsibility for the patients. The wards where the abuse took place were the subjectof two internal inquiries into allegations from 1996 and 1998.

Dr Hallewell told inquiry investigators that he had been made to feel "like a visitor" on the ward, and "had not known of the abuse". However, details of the 1996 internal investigation obtained by The Independent cast doubt on this claim.

They show that Dr Hallewell had been made aware of complaints about patients' treatment. The minutes of a meeting between him and the hospital's internal investigators to seek his thoughts on complaints are included in the final investigation report. They reveal that Dr Hallewell recognised that "physical restraint can create a bad impression".

He told investigators he was unaware that a patient had been fed on a commode but agreed "that this appeared to lack dignity". He believed several other practices - including "the use of banter" and concealing of medication in sweets - to be acceptable in some circumstances.

Yesterday's report by the CHI says: "The CHI is deeply disturbed by the consultant's lack of awareness and passive acceptance of being treated like a visitor on the ward where the abuse occurred. This reflects an inadequate sense of medical accountability in so senior a figure."

Among its 19 recommendations, it says: "The trust should examine the processes it has used in making senior appointments, and may wish toreview whether all such appointments have been appropriate."

And a Department of Health spokesman said: "We would want the trust to follow that through."

Meanwhile, a second report published by CHI yesterday into the Welsh hospital trust where a surgical blunder led to the wrong kidney being removed from a patient says an action plan to prevent a recurrence is being implemented too slowly.