A PATIENT group is calling for an inquiry into why North-East health bosses waited eight months to issue a national warning about a surgeon's competence.

The case has echoes of the Richard Neale affair which led to the disgraced North Yorkshire surgeon practising for years after concerns were raised by patients.

In both cases the authorities appear to have reacted slowly to protect patients.

In September 1999, officials at Bishop Auckland General Hospital raised concerns about orthopaedic surgeon William Agunwa with the Northern and Yorkshire regional office of the NHS Executive in Durham. The trust also notified the General Medical Council on November 10, 1999.

It followed three complaints from patients who had been treated by the locum consultant between December 1998 and March 1999 before he moved to Merseyside.

The complaints concerned the standard of joint replacement operations.

However, officials took until May 5, 2000, to issue a national alert letter, warning other NHS hospitals not to employ him.

By the time this reached Whiston Hospital in St Helens, it had been investigating Mr Agunwa's competence for months.

Concerns began shortly after Mr Agunwa joined Whiston Hospital in May 1999.

A subsequent Royal College of Surgeons investigation resulted in Mr Agunwa's suspension.

A spokesman for the Whiston Hospital said: "We don't know the reason for the delay in raising any concerns about his work but we have been quite prudent and proper in dealing with this problem."

Dr Bill Kirkup, director of public health for Northern and Yorkshire said: "Based on the evidence we had at the time I think we took the only decision which could have been taken."

He denied there had been any undue delay in taking action but said with the "benefit of hindsight" he wished that he had been able to get the evidence they needed at an earlier stage.

"This is not something you can do lightly because it is somebody's future livelihood at stake, but on the other hand as soon as the scales tip in favour of action then I have to act," said Dr Kirkup, who has the statutory responsibility within Northern and Yorkshire for issuing alert letters to the rest of the NHS.

In response to calls for an inquiry, Dr Kirkup said: "I am happy to involve anybody. If it needs a more formal review I am happy to go along with that."

He pointed out that changes in national legislation would soon mean that doctors who were under-performing would be investigated by a new body to be known as the National Clinical Assessment Authority.

"If there was a similar case in Bishop Auckland in the future then it would be referred to this new authority to assess the doctor before they could practice unsupervised," added Dr Kirkup.

But Mike Stone, director of the Patients Association, said: "This is just not good enough. I think there should be an inquiry into why such a delay occurred. Why did it take so long"

Mr Stone said the problem with the various health authorities and regions is that they tend not to talk to each other.

"It is all down to communication problems. It is almost like medieval fiefdoms," he said.

Carole Millward, a former patient of Richard Neale, said: "It is pretty frustrating that after all that we have been through this sort of thing is still going on. Of course there should be an inquiry."

Mrs Millward, who lives in Northallerton, North Yorkshire, and was a founder member of the Victims of Richard Neale support group, said she understood that doctors' careers were put at risk by such alert letters but this had to be set against potential danger to patients.

"We appreciate that it is somebody's career but that is nothing compared to somebody's life," she added.

Mr Neale was struck off the medical register last summer after the GMC found 34 our of 35 allegations against him proved.

A spokeswoman for the General Medical Council confirmed that they were aware of the William Agunwa case