Gynaecologist Richard Neale yesterday admitted that he shouted at a patient during a 20-minute row in his surgery.

Mr Neale is accused of behaving unprofessionally towards Mrs B in April 1995, when she went to see him to demand her medical records.

He told the General Medical Council's professional conduct committee that she and her husband followed him through the clinic and outside, where Mrs B called him "the worst doctor in the world".

He had performed an emergency hysterectomy on Mrs B in February of that year, after six years of treatment during which he is alleged to have failed to care for her properly.

In the following two months Mrs B had to have extensive treatment on the surgical wound, which had become infected.

She had asked Mr Neale for her records, but he had not supplied all the papers, so on April 5 Mr and Mrs B went to see him at his surgery.

"The purpose of her visit was to collect the medical records. I was amazed that somebody should travel all that way just to collect medical records. Anybody else would request them in a letter," Mr Neale told the hearing.

He said he refused to hand the records over and went on: "The conversation deteriorated. Voices became raised. She became very assertive. I have to confess to raising my voice. It was quite clear that we were into an adversarial situation."

He added: "I believe I behaved in a reasonable manner, despite considerable provocation."

Mr Neale, of Boroughbridge, near York, is accused of "incompetence over operations on 14 women at the Friarage Hospital, in Northallerton, and St Mary's Hospital, Newport, Isle of Wight.

He admitted failing to perform a pre-operative x-ray or post-operative mammogram on Mrs A to ensure that an area of calcifications had been successfully removed, but denies botching operations on other women. He also denies making false claims about his qualifications in an application for a post as an assessor of doctors' performance in h 1997.

The hearing continues.