A Barrister suggested to a jury this afternoon that they could not be sure that a retired York psychiatrist raped and indecently assaulted his patients.

Robert Smith QC was opening the defence for Dr William Kerr at Leeds Crown Court.

He said that Dr Kerr, accused of four rapes and 15 indecent assaults against women patients between the 1960s and 1980s, was not able to defend himself because of disability.

"He has suffered a severe physical illness resulting in physical damage to his brain," he said.

"He cannot go into the witness box. His illness has deprived him of the ability to understand the proceedings."

Mr Smith said the jury had to be sure that Dr Kerr had committed the alleged acts to find the prosecution case proven.

"Are you able to be sure without hearing his side of the story?" he asked.

A previous jury decided in April that Dr Kerr, 75 of Alne, near Easingwold, was unfit to plead because of mental impairment. The current hearing at Leeds is being asked to determine whether he committed the alleged acts. The jury was told that Dr Kerr denied all the allegations under police interview in 1997.

Earlier, Paul Worsley QC, prosecuting, said there was "an underlying pattern" to all the allegations of sexual assault and rape made against Dr Kerr.

He said all the victims were patients of the retired York consultant, not nurses; all were in a vulnerable condition; all were seeking treatment for depression; and each victim allegedly complied with Dr Kerr's demands because of his forceful personality.

"We invite you to consider there is an underlying pattern in all these allegations," Mr Worsley told the jury.

Written statements were read out yesterday from five of Dr Kerr's former secretaries, each of whom said they had never received any complaints about him or had any reason to suspect anything untoward was happening. Each had nothing but praise for him, commenting on how pleasant, professional and helpful he was.

One of them, who had been his secretary at Clifton Hospital, in York, said: "I got on very well with him and liked him and respected him."

"When I spoke to patients, frequently I received compliments about how good he was."

Mr Worsley said the case against Dr Kerr, who had been "the number one consultant psychiatrist in North Yorkshire", depended on whether or not the jury decided the 16 complainants had consented to sexual acts with Dr Kerr.

The case continues.