Dr Michael Watt: Concern over neurologist's contacts with patient

Dr Michael Watt is at the centre of Northern Ireland's biggest patient recall

Interactions with a patient by former Belfast Trust neurologist Dr Michael Watt have raised serious concerns, according to a medical ethics expert.

London-based barrister Daniel Sokol has reviewed evidence obtained by BBC Spotlight, including text messages between Dr Watt and the woman that were sent between 2017 and 2020.

Concerns over Dr Watt's clinical practice at Belfast's Royal Victoria Hospital prompted the biggest ever patient recall in Northern Ireland in 2018.

His work and its oversight is the subject of three ongoing high-level inquiries.

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Spotlight has asked Dr Watt for his account of his interactions but his solicitor told us Dr Watt's mental health had worsened over the past two years and he could not respond.

The woman, Jane, whose identity Spotlight has chosen not to reveal, first met Dr Watt in 2002. He diagnosed her with epilepsy.

Jane had suffered a miscarriage in the 1990s and later discovered tissue from her baby had been kept at the Royal Victoria Hospital without her knowledge.

She said she was traumatised and did not want to go back to the hospital.

She told Spotlight she then met Dr Watt in coffee shops and, for a time, the meetings were also medical consultations.

'Kissed her on the lips'

Barrister Daniel Sokol said: "A coffee shop is somewhere where you go and meet friends. It's not somewhere where you go and see a doctor.

"It's difficult in such a location to maintain privacy, it's difficult to maintain confidentiality. I think it does suggest a lapse of judgement on the part of the doctor here."

Jane told Spotlight that after a meeting with him in 2016, Dr Watt kissed her on the lips.

She said although she felt the kiss was inappropriate, she laughed it off because she did not like confrontation and still needed Dr Watt as her neurologist.

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Mr Sokol said all medical codes of conduct forbid a doctor pursuing a romantic or sexual relationship with a patient.

"Kissing on the lips clearly is an overstepping of the boundary - in fact it's not an overstepping, the boundary is a tiny line in the distance."

Dr Watt worked at Belfast's Royal Victoria Hospital as a neurologist

Later in 2016, a GP raised a red flag over Dr Watt's care. Then in June 2017, the neurologist was withdrawn from seeing patients.

Spotlight has obtained texts Dr Watt exchanged with Jane between October 2017 and January 2020.

'No funny business'

Mr Sokol told Spotlight he believes that even though Dr Watt was withdrawn from patient care during the period covered by the texts, he should have been behaving as though 'Jane' was still his patient.

"It appears this patient wants to re-establish the relationship, the therapeutic relationship, as soon as it's permitted and so therefore this doctor should treat this individual as a patient."

The messages show Dr Watt inviting Jane to his house when he is alone, adding "entirely safe" and "and no funny business x" via text message.

According to Jane, the "no funny business" meant "basically he won't attempt to kiss me again as he had done previously", which she did not trust would be the case, declining his invitation.

Dr Watt exchanged a number of texts with Jane (reconstruction of actual text)

Having reviewed the text exchange, Mr Sokol said that Jane could be considered vulnerable and dependent on Dr Watt and it was "particularly troubling" that Dr Watt had insisted she come to his house, saying at one point "oh go on".

But it's messages Dr Watt exchanged with Jane in the summer of 2019 that are most extraordinary.

At that time, patients and their families were anxiously awaiting a delayed report on the recall of patients, unaware it had been postponed because Dr Watt had been assessed as at risk of suicide.

He texted Jane around the time of that assessment, firstly indicating that he was off sick for financial reasons.

"Still hanging together. Now off on sick to try and prevent the buggers stopping paying me," he wrote.

Reconstruction of actual text

Dr Watt then mentioned to Jane that he had upcoming appointments with occupational health and psychiatry.

Then, a couple of weeks later, he sent the most extraordinary message of all after Jane texted to ask him how those appointments had gone.

"They've concluded a significant risk of me topping myself and have postponed the publication of the recall results," he wrote, followed by two 'crying with laughter' emojis.

'Absolutely outrageous'

We asked Dr Watt for his account of all of the text exchanges but his solicitor said the deterioration in his mental health over the past two years left him unable to respond.

So while Spotlight has seen the text messages, we only have 'Jane's' account of the circumstances and not Dr Watt's.

And it's important to remember that a single text message does not provide a clear and detailed insight into Dr Watt's mental state either then or now.

Spotlight showed some messages from summer 2019 to Therese Ward, a former patient of Dr Watt, who, like others, has been anxiously awaiting the publication of the recall results.

"It's just incredible. That he would put in a message, in a Whatsapp message to a former patient, that there was 'a significant risk of me topping myself and have postponed the publication of the recall results' and he laughs.

"He is laughing at us patients. I find that outrageous, absolutely outrageous that he finds this funny."

In a statement, Dr Watt's former employer, the Belfast Trust, said it was co-operating with all inquiries related to Dr Watt's care and would ensure the matters raised by Spotlight would be brought to the attention of all relevant bodies.