In April 1993, Jeanette Godden went to Kent's Royal Victoria hospital for a routine ante-natal check-up. She was seen by a GP, Clifford Ayling, who had a surgery in Folkestone and a qualification which allowed him to carry out locum gynaecological sessions at hospitals in the area. He worked with Rodney Ledward, the disgraced gynaecologist who died last year, and it was Ledward that she had been due to see that day.

Once inside the consulting room Ayling took her blood pressure, commented that it was higher than usual and said it must be because she found him attractive, as did most women. According to Godden, 33, he asked her to undress from the waist up, inquired if she intended to breastfeed and when she said yes, fondled her breasts and began to tweak her nipples painfully, saying they needed to be toughened up for breastfeeding.

"He cupped my breasts with his hands. This examination continued for several minutes during which I began to cry with the uncomfortable pain," says Godden. Next, Ayling told her he was going to carry out an internal examination. She refused to allow it because of the pain he had just subjected her to but he warned her that the examination was necessary to pick up cysts, cancer or other growths inside her womb or fallopian tubes.

When she continued to refuse, Godden says: "Dr Ayling became very angry and stated that if I was happy to have a disabled or handicapped child then I must sign my obstetric notes to say that I had refused an internal examination and the health authority would not be held responsible. I was terrified and agreed to the examination."

Her instinct to refuse proved right. Ayling asked her to undress from the waist down, placed his left hand on the inside of her right thigh and inserted his fingers into her vagina, moving them in and out, as though simulating sex.

She left the consulting room in a daze and back at home scrubbed herself obsessively in the bath to remove all traces of the assault.

Godden's experience highlights just how problematic this most sensitive part of the doctor-patient relationship can be. While most doctors behave appropriately when carrying out intimate examinations there are too many who take advantage of their position, presume that women will defer to instructions and gamble that they will not be aware of their rights as they lie embarrassed and partially undressed on the couch with their legs open.

Peter Bowen-Simpkins, a consultant gynaecologist and spokesman for the Royal College of Obstetricians and Gynaecologists believes that change is necessary. "I'm ashamed to say that yes, doctors are still seen as gods by patients," he says.

But even if patients who have been taken advantage of complain, redress is not always forthcoming. Godden did complain and received an "unreserved apology" from the hospital. She was told that Ayling would never again be allowed to take an ante-natal clinic at any of the south-east Kent hospitals unless one of his own patients requested it, in which case, the patient would be chaperoned by a qualified midwife.

"As a result of this assault, I suffered from panic attacks, nightmares, severe depression and stress for weeks. I did not have sex for nearly two years," says Godden. However, she was comforted by the fact that her complaint appeared to have been taken seriously.

What she did not discover until 1998, when Ayling was charged with 21 counts of indecent assault against patients, was that the hospital had already received several serious complaints about Ayling before hers. And although he was barred from ante-natal clinics following her complaint he continued to assault women at his surgery and at family planning clinics. One of his assaults was recorded on a woman who visited his surgery to have a coil fitted just weeks before he went to trial for the indecent assaults. He was convicted of 13 counts of indecent assault involving 10 women between 1991 and 1998. Not guilty verdicts were returned on five counts involving another three patients. Ayling was jailed for four years last December.

The health secretary, Alan Milburn, announced an inquiry following Ayling's conviction, to see what steps might be taken to stop abusive doctors. However, little progress appears to have been made. A department of health spokesman says that legal advice is being sought on behalf of the government about the format the inquiry should take.

While doctors who abuse patients form a minority of the profession, both the General Medical Council and the police investigate such complaints regularly. The GMC says it has tightened up procedures so that officials can now suspend a doctor at a much earlier stage.

Sarah Harman, of Harman and Harman, a Canterbury firm of solicitors, is representing some of the women - 15 to date - who suffered at Ayling's hands, in the first group action of its kind. They are all suing him for sexual assault. She believes that there are many lessons to be learnt about how doctor-patient relationships should best be handled and is urging Milburn to make the inquiry a public one. "I'm prepared to judicially review the government's decision if this inquiry is not held in public," she says.

"We need to learn the lessons from what happened with Dr Ayling and if matters are not aired in public we won't be able to learn any lessons. For these women being sexually assaulted was bad enough but their distress was compounded by the fact that the assaults were a breach of trust. They felt they would not be believed because Ayling was a doctor."

A spokesman for East Kent NHS hospitals trust says that procedures have changed and anyone accused of assaulting a patient would be suspended immediately pending inquiry.

The Royal College issued guidelines in 1997 for doctors' conduct when carrying out intimate examinations. Bowen-Simpkins says that they are currently being revised and when the new guidelines are drawn up in a few months' time they are likely to urge doctors to take precautions in stronger terms.

Godden is angry and bitter. "I really hope Alan Milburn makes the inquiry public so Ayling can be named and shamed. There was - and remains - a conspiracy of silence within the establishment and an unwillingness to blow the whistle on unscrupulous and rogue doctors.

"He could have been stopped as long ago as 1991 when the earlier complaints were made. Everyone, from the cleaners to the other consultants, knew what he was doing."