Deviant Devon doctor allowed back to work after secret shower filming
Staff at a Devon hospital trust which employed paedophile doctor Alexander Knight had concerns about him but felt they would not be listened to by bosses, a review found. The 54-year-old, who was known as Alexander Grice at the time, was an anaesthetist at the Royal Devon and Exeter Hospital when he was arrested in June 2022.
He was jailed for 20 months in March 2024 after admitting downloading 14,000 child abuse from the dark web. Officers and police experts who viewed the images he collected described them as some of the most depraved they had ever seen. They were so appalling in nature that health advice was offered to those who viewed the material.
His conviction "sent shockwaves" through The Royal Devon University Hospital Foundation Trust, an external review says. None of the images were taken on RDUH premises and there was praise for most of the Trust's handling of Knight.
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But the Trust has been told to improve its culture of sexual safety and speaking up as result of the 'lessons learned' report. The external review looked at how the the Trust managed the consultant anaesthetist during the period before his final arrest.
Knight was convicted in France in 2017 for secretly filming in a shower block at a campsite. Despite the conviction he was allowed back to work, with restrictions, after convincing a tribunal his offending was not motivated by sexual deviancy but by a mental health condition. This was backed up by three psychiatrists who gave evidence to a tribunal.
In 2018, Knight went back to work after a risk assessment found he could be managed if a number of conditions were met. The plan focused on his mental wellbeing and not his behaviour in France.
The review found that there were “different views” among different staff groups about Knight. Some non-medical staff had previously heard "gossip" about him using porn at home and were concerned about "sexually inappropriate" behaviour as he moved about within anaesthetic rooms.
Some of his behaviour in operating theatres was considered "at the outer limits of normal", particularly his "involvement in the positioning and preparation of female patients for surgery", says the review.
But staff "felt that the culture at the time inhibited any thought of them raising a concern about this."
Consultants were split about whether the doctor should return to work. Medical managers, who did not have the full context, prioritised the doctor's mental health and thought there might be a "witch hunt" against him.
"The doctor’s practice of undertaking female catheterisation, was also raised," said the review. "The number of these undertaken was considered to be on the outer limits of what would be considered normal practice for an anaesthetist." Knight said it saved time.
The review also highlighted episodes after he returned to supervised work and before his final arrest, including viewing a streaker in theatre on his mobile phone and removing a vial of medication.
Knight is said to have made "a lewd comment" to a female member of staff. There was also a second incident with another member of staff in December 2020 during which she had to squeeze past him and he remarked, 'Oh, you have a firm bottom'.
As a result of the second incident a minor misconduct letter was issued and the doctor told to apologise to the member of staff.
In May 2022, a staff member reported that the doctor had been seen "looking at a picture of a naked woman" on his phone whilst working in theatres.
"This picture appeared to show a woman naked from the waist up and it appeared as though the woman was covered in a drape, similar to those used in operating theatres," said the review. This led to Knight being arrested. Electronic devices were seized from his home.
On March 8 at Exeter Crown Court, Knight of East Street, Chulmleigh, and formerly of Poughill, Crediton, admitted three counts of making, by downloading, indecent images of children, and possessing prohibited and extreme images.
The review concluded that no one in the Trust was to blame for what happened, only Knight.
But it said the Trust had to improve its culture of speaking up and sexual safety. "Many people who took part in this review describe feeling unable to speak up, or if they did speak up, an experience of not being heard, their concerns not being valued, or being dismissed, not understood," it concluded.
It adds. "The people who experience this were those attempting to raise concerns with people who were perceived as more senior to them, higher up in the hierarchy, importantly, people felt that their voices were much less likely to be heard if they were female and this was not always dependent on position."
It said it was "principally women who experience unsafe sexual culture", adding: "This review demonstrates a lack of clarity and understanding about what constitutes a safe sexual culture in the RDUH, the behaviours expected in a safe culture and the impact of unsafe sexual behaviours on those affected by them."
The Trust said in a response: "This is a particularly distressing criminal case and the Trust commissioned an independent review to help us understand what we could learn from it. We accept all the recommendations of the review."
"The review concludes that no one in the Trust is to blame for what happened and that the responsibility for his actions lies with Alexander Knight. It finds that the systems we have in place contained the situation, ensured close cooperation with other agencies and the police and ultimately led to his conviction.
"The review also concludes that there are two areas where the Trust could make improvements. One is our culture in relation to sexual and psychological safety and we have already begun a programme of work to address this. The other recommendation is that we review the systems and processes we have in place for the management of doctors.
"The police were able to confirm through geolocation that none of the images from the criminal case were taken at the Trust. Nevertheless we understand that this news may be very distressing to read, if you would like to talk and share any concerns you can contact our helpline on 01271 314090."