The North Yorkshire Emergency Doctors have been criticised by the York coroner after an elderly woman was confirmed dead by two unqualified care assistants because a doctor refused to attend.

And a question mark has been left over the exact cause of death of 86-year-old Hilda Watson, on January 16, last year, at Rosevale Residential Home, Wigginton, because relatives saw an unexplained bruise on her temple.

When Jean Hammond, night team leader at the home, found Mrs Watson's body in the early hours of January 16, she called the North Yorkshire Emergency Doctors (NYED), and was told by the GP on duty, Dr John Hamilton, that he did not need to attend.

Dr Hamilton told the inquest in York: "About a year before this incident we were circulated with information to say that there would no longer be a requirement for GPs to visit where there were no relatives or other persons to be cared for at the scene of an expected death."

The inquest heard Mrs Watson's body was taken to a funeral home the same night and her GP, Dr Elizabeth Fowler, issued a death certificate, without seeing the body, giving bronchio pneumonia and heart disease as the cause of death based on her medical history and a recent chest infection.

Dr Fowler said: "If there had been anything from Rosevale that had made me think there was anything unnatural about the death I would have contacted the coroner's office."

Neither Dr Fowler nor Mrs Watson's relatives were told that her body had been found slumped against the end of her bed, but this information emerged later when her daughters made a complaint and an investigation was carried out.

It was then that Ruth Brown, her daughter, remembered a one-and-a-half inch bruise she had seen on her mother's temple several days after the death.

Solicitors for both doctors and the residential home were present at the inquest.

The coroner, Donald Coverdale, said: "I believe the bruising developed post mortem.

"What I don't know is whether any such head injury has contributed to the death.

"I have to say that the cause of death is unascertained and in these circumstances it follows that the verdict is an open verdict.

"It concerns me considerably that the North Yorkshire Emergency Doctors will accept the word of unqualified carers within a residential home that a person has died, and that subject to liaison with relatives, that the next move is for an undertaker to remove the body. It is unsatisfactory and I propose to make representations to the North Yorkshire Emergency Doctors about this state of affairs."

After the inquest, Mrs Watson's daughter, Ruth, said: "This hasn't taken away the feeling that things weren't right."

Dr Jamie Macleod, chairman of NYED, said today: "I would welcome joining this debate with the coroner. Anyone can confirm death, it's not and never has been a legal requirement or duty for a doctor to do that, but we do offer comfort to families where that is appropriate.

"Certification of death is a legal requirement of a doctor but it is not necessary for the doctor to see the body unless the patient is to be cremated. Our duty of care is to the living."

Updated: 11:47 Thursday, June 21, 2001