A FAMILY doctor accused of murdering three of his patients heard doctors testify in court that the doses of morphine he prescribed were up to 12 times higher than usual.

Dr Howard Martin, 71, is accused of murdering Frank Moss, 59, Stanley Weldon, 74, and Harry Gittins, 74, by giving them overdoses of morphine.

Dr Martin, who practised in Newton Aycliffe, but now lives in Penmaenmawr, Conwy, North Wales, denies murder.

Teesside Crown Court has heard how retired County Durham medic Dr Martin administered fatal doses of morphine into the three men.

He gave doses of 60mgs of morphine to each of the very ill men. However Mr Gittins had been taking morphine tablets for pain before he was treated by Dr Martin and may have built up a tolerance.

However in court Dr Peter Robson, a palliative care specialist who has treated elderly terminally ill patients for more than 20 years, said that doses of 60mg should only be used "in extremis."

He said: "It would be something to use if the patient had only minutes to survive. By way of illustration and acute heart attack patient might get 10mgs of morphine intraveneously. It would be 10mgs for acute, severe pain."

Asked what would happen if a patient was given too much morphine he said: "Too much morphine will result in the death of a patient." He explained that morphine depresses the breathing mechanism.

Dr Robson said that often doses would start at 5mg to 10mgs and the patient would be monitored. Often nursing agencies, like the MacMillan nurses would be used.

Dr Martin has criticised in court by prosecuter Robert Smith, QC, who said patients were not monitored for up to eight hours between doses of morphine.

Anthony Arlidge, defending, asked Dr Robson whether he was aware that practices were often different in community practices were often behind the times and that patients often declined to tell relatives the extent of their suffering. Dr Robson agreed that was the case.

Dr John Grenville, who advises GPs on keeping up to date with modern practice in Derbyshire, said dosing very ill patients was "not an exact science," but agreed that 5mg to 10mg was the usual starting point.

Dr Martin was charged with the murders after the men's bodies were exhumed and subjected to forensic tests.

He is accused of murdering Mr Moss, of New Row, Eldon, on March 14, 2003; Mr Weldon, from Kimberley Street, Coundon, five days later; and Mr Gittins, of Newton Aycliffe, on January 22, 2004.

The trial continues.