A Croydon doctor who told a pensioner with terminal bowel cancer she had piles has been allowed to carry on practicing.

Dr Chandra Pawa failed to diagnose 70-year-old Iris Marina Graham from Cleves Crescent, New Addington, correctly - despite her telling him her father had died from the disease.

He denied this during a General Medical Council hearing.

Dr Pawa told her "not to worry" when she had a consultation with him at the Fieldway Medical Centre, New Addington, instead attributing the symptoms to haemorrhoids.

They were also told how he failed to examine Mrs Graham's rectum and abdomen or take a blood test despite seven consultations over a 10-month period at the surgery and how he only agreed to carry out an examination after pressure from her family.

By the time he realised his error, Mrs Graham weighed just seven stones and the cancer had already spread to her liver and lungs. She died months later on May 7, 2005, in a nursing home.

However, despite finding Pawa guilty of repeatedly failing to carry out an examination on Mrs Graham, failing to take a blood test, failing to ask about her symptoms and failing to refer her for urgent specialist treatment, the GMC ruled that he can return to work under supervision.

He was told last Wednesday that for the next 18 months he must work with a medical expert to address the problems in his work - specifically the assessment of bowel disorders and the management of elderly patients.

He was also ordered to "go back to the classroom" for further courses in the examination of bowel conditions and the diagnosis and assessment of elderly patients.

Mrs Graham's family are believed to be disappointed with the ruling.

It also emerged during the hearing that five years ago, Dr Pawa - who has been a GP since 1974 - was found guilty of serious professional misconduct for the poor management of a nursing home.

He admitted inadequate care and treatment was given to elderly patients and that they were allowed to physically deteriorate and did not have their dignity respected.

Following this Pawa was told he must learn how better to deal with elderly patients.

And in 2003 Pawa made another appearance before the GMC accused of failing to refer 75-year-old Violet Smith from Fieldway who had a serious stomach complaint to hospital experts.

Although he told the housebound pensioner that her illness was "only gas" shortly before she died, the committee found that his failure to make notes about one of the consultations was not enough to support a finding of serious professional misconduct.

Chairman of the GMC panel, Dr Peter Jeffreys, said: "We are concerned that you have an attitudinal problem, or limited skill, in assessing elderly patients in a comprehensive way."

Speaking about Mrs Graham, he added: "Although your failures were confined to one patient, you repeatedly failed to think afresh about the possible causes of her bowel symptoms.

"The onus was firmly on you to discount cancer as a cause by taking a full history, examination and investigation and urgent specialist referral.

"The panel had no doubt that your conduct has fallen below the standard that the public is entitled to expect from a registered medical practitioner."

Dr Pawa said: "I wish to extend my deepest sympathy to the family for their loss. I have been a GP for 30 years and in that time have built up a good rapport with my patients. I would like to reassure them that I strive at all times to act in their best interests. I will fully observe the conditions required by the GMC as I continue to work at the Fieldway Practice."