Dr. François Simon was one of the many people who knew that Joël Le Scouarnec had been convicted of downloading child sexual abuse imagery in 2005 and was continuing to operate on children as a gastric surgeon.
More than a decade later, the French police arrested Mr. Le Scouarnec. They would eventually charge him with the rape or sexual assault of 299 former patients, most of them children.
Dr. Simon was the head of an official board that oversaw doctors in Finistère, Brittany, where Mr. Le Scouarnec was employed in the late 2000s. He was among several people in France’s elaborately bureaucratic health system tasked with addressing Mr. Le Scouarnec’s initial criminal conviction.
Like many, in the end, he dropped the ball. He could have called for a disciplinary hearing, but instead, he sent the verdict up to the Ministry of Health’s departmental branch. He told a court this month that he had believed that office could address it more urgently. His own board voted almost unanimously that Mr. Le Scouarnec’s actions had not breached the medical code of ethics.
“We tried to do what we could,” Dr. Simon, who is now retired, said in a courtroom in Vannes, a Brittany port town, where he had been summoned as a witness against his will. “I can’t say there was a malfunction, but I regret it because there was a misunderstanding.”
After three long months of testimony, the trial over what is considered the biggest pedophilia case in French history is coming to an end.
There is no suspense regarding the verdict, scheduled to be handed down Wednesday. Part way through the trial, Mr. Le Scouarnec said he was guilty of sexually assaulting or raping all the victims, and possibly others, over 25 years of working in nine clinics and hospitals in western and central France.
But questions still haunt the case, particularly about why no one caught Mr. Le Scouarnec over that time, or even suspected him; and why, after he was convicted of visiting websites featuring the sexual abuse of children, no guardrails were put in place to protect his patients.
No fewer than 10 administrators were called before the court in search of answers. Most were long retired, offering foggy memories and answers filled with mind-numbing acronyms and administrative jargon. Very few took any responsibility — most blamed other wings of the bureaucracy or said that Mr. Le Scouarnec’s 2005 conviction had not warranted special attention since the courts had not demanded any oversight.
“The analysis of the situation was correct at that time,” insisted Bernard Chenevière, a retired administrator from the health ministry’s hospital service. “There was no link between the initial conviction and all the incredible events that took place afterward.”
The result of this inertia was a “collective shipwreck” said Jean-Christophe Boyer, one of many child protection lawyers acting in the case.
“There was only one guilty person here,” he told the court during his closing statement, “but there are many responsible.”
The scale of Mr. Le Scouarnec’s crimes came to light after he exposed himself to a 6-year-old neighbor in 2017, and her parents told the police. He stood trial and was convicted in 2020 of the rape and sexual assault of four females, including the girl next door and two of his nieces. He was sentenced to 15 years in prison.
The evidence pointing to hundreds of other victims, male and female, was unearthed after investigators dug through his personal diaries as well as two spreadsheets, discovered on hard drives, that listed the names of his victims and the abuse they had suffered, sexual assault and rape, mostly related to penetration with fingers. Many were abused while sedated or recovering from operations.
Their average age was 11.
In court, many of Mr. Le Scouarnec’s former colleagues said they had seen no signs of his perversion. They described him as quiet and friendly, and as a very good surgeon.
But there was one clear warning sign: his 2005 conviction after an international F.B.I. investigation that snared thousands who had viewed child sexual abuse imagery. A French court at the time gave him a four-month suspended sentence, but demanded no psychological treatment, as it had for others. Nor did it restrict his medical practice. And the court failed to notify Dr. Le Scouarnec’s medical clinic, despite a law requiring it to do so.
Dr. Thierry Bonvalot, a psychiatrist who worked in the same hospital as Mr. Le Scouarnec in the small town of Quimperlé, was tipped off by someone in the court. After confronting Mr. Le Scouarnec, he wrote to the head of the hospital.
Dr. Bonvalot questioned whether Mr. Le Scouarnec “could remain calm while interacting with young patients.” He later forwarded the letter to the local oversight board of doctors, headed by Dr. Simon.
Dr. Simon had to call the court five times to confirm the conviction. He then held a meeting with Mr. Le Scouarnec.
Confronted about his criminal record, Mr. Le Scouarnec described it as a blip after having split up with his wife. He said he had fallen into depression, had been drinking and scrolling through pornographic websites, and had gone to ones involving children “by accident,” recounted Mr. Simon in court.
“I took him at his word,” he said.
From there, the information traveled through multiple layers of health ministry bureaucracy — to the departmental arm, the regional arm, the headquarters in Paris, and through two doctor oversight boards.
Yvon Guillerm, who was the deputy director of the regional health agency, alerted his higher-ups in Paris and was instructed to file a professional complaint with the regional oversight board of doctors, which could rule to bar Mr. Le Scouarnec from practicing medicine. But he never did. He said in court that it was his boss’s job. That boss has since died.
“I am willing to admit there were a few deficiencies in the process,” he said.
His boss did call the head of another hospital in the region to caution the director not to hire Mr. Le Scouarnec, who was set to begin filling in there. But that warning was not sent outside the region.
Mr. Le Scouarnec, who didn’t hide his conviction, appears to have benefited from administrative overlap and disorganization, as well as the desperate condition of some rural hospitals that were struggling to remain open because of a lack of medical staff.
When the Quimperlé hospital closed its surgical unit, he moved 290 miles south to another region. There, the local medical board approved him, despite learning about his conviction.
He was hired by a hospital director in the town of Jonzac, Michèle Cals, who told the court that the only person who informed her of the conviction was Mr. Le Scouarnec himself. But he arrived with a glowing recommendation from his last hospital, and the health ministry had approved his hiring.
“So what else did you expect me to do? Nothing?” said Ms. Cals, who retired a year after hiring him. “At the time, there were few applications and many vacancies, everyone was looking for surgeons. If he hadn’t been hired in Jonzac, he would have been hired anywhere else.”
All of this meant that Mr. Le Scouarnec, now 74, could continue sexually abusing his patients.
“It reinforced my feeling of impunity,” he told the court.
For Gabriel Trouvé, who was abused by Mr. Le Scouarnec when he was 5, the lack of acknowledgment of responsibility coupled with an apparent lack of introspection from officials on the stand was infuriating.
“It’s scandalous, actually, because we are well aware that it’s a systemic problem,” said Mr. Trouvé, now 34. He is among the members of a new collective of the doctor’s victims calling on the government to launch a commission into sexual abuse and the medical system. The Justice Ministry has agreed to meet with the collective.
“The state must act on what just happened because if it doesn’t, than our experience and the experience of this whole trial, will be reduced to very little,” said Mr. Trouvé. “ And that’s not acceptable.”
The irony, Mr. Trouvé pointed out, was that one of the few officials to show remorse was the whistle blower, Dr. Bonvalot. He offered the victims a tearful apology in court, saying that he was wracked with guilt over what more he should have done.
“I see this as a dramatic personal failure,” Dr. Bonvalot said.
Catherine Porter is an international reporter for The Times, covering France. She is based in Paris.
Ségolène Le Stradic is a reporter and researcher covering France.
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