TRUST me, they used to say, I'm a doctor. And we believed them. But that was before we had heard of Harold Shipman, Rodney Ledward and Richard Neale. Now it is unlikely that any patient will again place unconditional trust in the medical profession.

In some ways the case of gynaecologist Richard Neale is the most disturbing of all the recent high profile medical scandals. The fact that he was an inept physician whose botched surgery devastated many lives is, unfortunately, not unique. Neither was his unswerving arrogance, bolstered by the "consultant is king" hospital culture.

What makes this horror story so much worse is the despicable way the health authority colluded to cover up this man's incompetence.

Both the Yorkshire Regional Health Authority and the General Medical Council knew in 1986 that Neale had been struck off by the Canadian licensing authorities after the death of one of his patients. No action was taken.

Twelve years later Neale was finally suspended. The outcome: he leaves the Friarage Hospital with a £100,000 pay-off and a positive reference. This allows him to walk into another job and continue conducting surgery that he was clearly unfit to perform.

The doctor-patient relationship is never more intense than that between a woman and her gynaecologist. She places her very womanhood into the care of her doctor. Richard Neale abused that faith; dozens of women now bear the emotional and physical scars of his treatment.

Nevertheless, a group of these women rallied the strength to take on Neale and, as it turned out, the entire medical establishment. Only through their tenacity was he finally revealed and disgraced.

That means one of their objectives has been met. The other is to ensure that this can never happen again.

The unchallenged power of the consultant is already under investigation, after another incompetent obstetrician, Rodney Ledward, was exposed. Only one outcome is acceptable: a total overhaul of the system so that patients receive the level of protection that has been routinely reserved for consultants.